慢性乙肝病毒携带者瘀血阻络型病毒反转录酶区基因突变的研究(1)
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摘要：目的：检测未经治疗的慢性乙肝病毒(HBV)携带者瘀血阻络型和无症可辨型病毒反转录酶(Reverse transcriptase RT)区常见的核苷(酸)类似物(nucleoside analogue NA)12个耐药位点的基因序列，明确是否存在基因突变，明确两组不同中医证型的慢性HBV携带者在HBeAg水平、HBVDNA载量和基因突变方面是否存在差异。方法：选取慢性HBV携带者瘀血阻络型和无症可辨型各30例，检测血液乙肝三系定量，HBVDNA水平，并进行HBVRT区基因测序，chromas2.23软件分析核苷酸及氨基酸序列。结果：慢性HBV携带者瘀血阻络型HBeAg水平和HBVDNA载量低于无症可辨型，两组之间比较差异有统计学意义(t=2.268和3.908，P<0.05)；瘀血阻络型有3例患者发生基因突变，突变类型：rtV173L +rtL180M+rtM204V、rtS213T和rtV214I；无症可辨型患者未检测到基因突变。结论：慢性HBV携带者瘀血阻络型病毒复制水平较低，在HBV RT区常见NA耐药位点存在基因突变，提示瘀血阻络型患者在NA抗病毒治疗前应进行基因测序，避免使用存在耐药风险的药物。
关键词： 肝炎病毒，乙型；突变；慢性乙肝病毒携带者；中医分型
中图分类号：R512.62文献标识码：A文章编号：1673-7717(2012)03-0547-02
Research on Gene Mutation of Reverse Transcriptase Polymerase
in HBV Carriers with Virus of BloodStasis Type
WENG Weidong，LI Fangqiong，JIANG Kai，ZHU Yinghong
(Tongde hospital of Zhejiang province ,Hangzhou 310012,Zhejiang,China)
Abstract:Objective：To identify the untreated chronic HBV carriers with blood stasis type and asymptomatic patients HBV RT polymerase region common NA 12 resistance loci gene sequence. To investigate whether the presence of mutation and the different syndrome type of traditional Chinese medicine on the level of HBeAg and HBVDNA and common NA resistance loci gene mutations exist difference.Methods: Select chronic HBV carriers of blood stasis type and asymptomatic type 30 cases for each,hepatitis B antigen and antibody quantitative analysis and the levels of HBeAg were detected, Fluorescence quantitative PCR of serum HBVDNA levels were detected,and gene sequencing, Chromas 2.23 software was used for analysis of HBV RT gene mutation.Results:Chronic HBV carriers of blood stasis type HBeAg level and HBVDNA load below the asymptomatic sensible, between the two groups had significant difference(t=2.268、3.908，P<0.05), 3 cases were detected gene mutation in blood stasis type,mutation:rtV173L+rtL180M+rtM204V,rtS213T, rtV214I. Asymptomatic patients were not detected mutations.Conclusion:Viral replication level is low in blood stasis type,blood stasis type exists gene mutation in the HBV RT area common NA resistance loci ......
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