现代医药卫生
現代醫藥衛生
현대의약위생
MODERN MEDICINE HEALTH
2015年
7期
991-992,995
,共3页
肝炎,乙型,慢性%肝炎病毒,乙型%拉米夫定%DNA,病毒
肝炎,乙型,慢性%肝炎病毒,乙型%拉米伕定%DNA,病毒
간염,을형,만성%간염병독,을형%랍미부정%DNA,병독
Hepatitis B,chronic%Hepatitis B virus%Lamivudine%DNA,viral
目的：采用Taqman荧光探针技术对慢性乙型肝炎（乙肝）患者血清中乙肝病毒P基因区550位点的突变情况进行检测，对该院慢性乙肝患者乙肝病毒YMDD突变情况进行调查，为指导临床使用拉米夫定对乙肝患者进行治疗提供重要的参考依据。方法2013年2~12月选取HBV DNA定量在2.00E+03 IU以上的慢性乙肝患者186例，其中90例未经过治疗（未治疗组），96例使用拉米夫定治疗1年以上（治疗组）。其血清采用聚合酶链式反应结合Taqman荧光探针技术，分C、I、V三组，分别对总HBV DNA（包括野生型和突变型DNA），YIDD突变DNA，YVDD突变DNA进行检测。结果186例慢性乙肝患者中发生P基因区变异者共87例，其中治疗组患者发生YIDD变异9例（9.4%），发生YVDD变异36例（37.5%），YIDD和YVDD同时变异6例（6.2%）；未治疗组患者发生YIDD变异6例（6.7%），发生YVDD变异24例（26.7%），YIDD和YVDD同时变异6例（6.7%）。两组患者YIDD变异、YVDD变异及YIDD和YVDD同时变异发生情况比较，差异均无统计学意义（χ2=0.011、0.156、0.206，P>0.05）。结论经过拉米夫定治疗的患者乙肝病毒P基因区发生变异的频率高，但未经治疗的慢性乙肝患者体内的乙肝病毒也可自然发生P基因区的变异，故在治疗前及治疗中进行耐药基因的检测对指导临床治疗用药具有重要意义。
目的：採用Taqman熒光探針技術對慢性乙型肝炎（乙肝）患者血清中乙肝病毒P基因區550位點的突變情況進行檢測，對該院慢性乙肝患者乙肝病毒YMDD突變情況進行調查，為指導臨床使用拉米伕定對乙肝患者進行治療提供重要的參攷依據。方法2013年2~12月選取HBV DNA定量在2.00E+03 IU以上的慢性乙肝患者186例，其中90例未經過治療（未治療組），96例使用拉米伕定治療1年以上（治療組）。其血清採用聚閤酶鏈式反應結閤Taqman熒光探針技術，分C、I、V三組，分彆對總HBV DNA（包括野生型和突變型DNA），YIDD突變DNA，YVDD突變DNA進行檢測。結果186例慢性乙肝患者中髮生P基因區變異者共87例，其中治療組患者髮生YIDD變異9例（9.4%），髮生YVDD變異36例（37.5%），YIDD和YVDD同時變異6例（6.2%）；未治療組患者髮生YIDD變異6例（6.7%），髮生YVDD變異24例（26.7%），YIDD和YVDD同時變異6例（6.7%）。兩組患者YIDD變異、YVDD變異及YIDD和YVDD同時變異髮生情況比較，差異均無統計學意義（χ2=0.011、0.156、0.206，P>0.05）。結論經過拉米伕定治療的患者乙肝病毒P基因區髮生變異的頻率高，但未經治療的慢性乙肝患者體內的乙肝病毒也可自然髮生P基因區的變異，故在治療前及治療中進行耐藥基因的檢測對指導臨床治療用藥具有重要意義。
목적：채용Taqman형광탐침기술대만성을형간염（을간）환자혈청중을간병독P기인구550위점적돌변정황진행검측，대해원만성을간환자을간병독YMDD돌변정황진행조사，위지도림상사용랍미부정대을간환자진행치료제공중요적삼고의거。방법2013년2~12월선취HBV DNA정량재2.00E+03 IU이상적만성을간환자186례，기중90례미경과치료（미치료조），96례사용랍미부정치료1년이상（치료조）。기혈청채용취합매련식반응결합Taqman형광탐침기술，분C、I、V삼조，분별대총HBV DNA（포괄야생형화돌변형DNA），YIDD돌변DNA，YVDD돌변DNA진행검측。결과186례만성을간환자중발생P기인구변이자공87례，기중치료조환자발생YIDD변이9례（9.4%），발생YVDD변이36례（37.5%），YIDD화YVDD동시변이6례（6.2%）；미치료조환자발생YIDD변이6례（6.7%），발생YVDD변이24례（26.7%），YIDD화YVDD동시변이6례（6.7%）。량조환자YIDD변이、YVDD변이급YIDD화YVDD동시변이발생정황비교，차이균무통계학의의（χ2=0.011、0.156、0.206，P>0.05）。결론경과랍미부정치료적환자을간병독P기인구발생변이적빈솔고，단미경치료적만성을간환자체내적을간병독야가자연발생P기인구적변이，고재치료전급치료중진행내약기인적검측대지도림상치료용약구유중요의의。
Objective A total of 550 locus mutations of hepatitis B virus in the P gene region was detected by Taqman fluorescent probe among the patients′serum with chronic hepatitis B. A survey on patients with hepatitis B virus YMDD mutations in this hospital were conducted to guide the clinical use of lamivudine and provide an provide an important reference in clinic . Methods It was collected 186 chronic HBV patients from February to December of 2013 ,whose HBV DNA quantification was more than 2.00E+03 IU,in which,90 patients were deemed as the non—treatment group and 96 as the treatment group with lamivu—dine for over 1 year. These patients′serum was detected by polymerase chain reaction combined with Taqman fluorescent probe and divided into group C,I and V,and detecting their total HBV DNA(the wild—type and mutant DNA),YIDD mutant DNA and YVDD mutant DNA respectively. Results There were 87 cases with P gene variation among the 186 patients with chronic HBV , in which,9 cases in the treatment group had YIDD variation,accounting for 9.4%,36 cases occurred YVDD variation,accounting for 37.5%,6 with YIDD and YVDD variation,accounting for 6.2%;6 cases in the non—treatment group had YIDD variation,ac—counting for 6.7%,24 cases occurred YVDD variation,accounting for 26.7%,6 with YIDD and YVDD variation,accounting for 6.7%. The variations of YIDD,YVDD and YIDD&YVDD were compared simultaneously. The difference was statistically signifi—cant(χ2=0.011,0.156,0.206,P>0.05). Conclusion The patients treated by lamivudine were of high occurrence of mutations in hepatitis B virus P gene region. The chronic hepatitis B patients without the treatment occurred naturally variation of hepatitis B virus P gene region. Therefore,detecting drug—resistant gene before or during the treatment is important in guiding clinical therapy.
