| 摘要: |
| 目的 了解乙型肝炎病毒(HBV)逆转录酶区N236T单独突变患者与逆转录酶区N236T+A181T联合突变患者核苷(酸)类药物应用情况和病毒学特点的异同。方法 对发生HBV逆转录酶区N236T单独突变与逆转录酶区N236T+A181T联合突变的慢性乙型肝炎患者的血清HBsAg、HBV DNA和丙氨酸转氨酶(ALT)水平进行检测和HBV基因分型,并对所有患者的核苷(酸)类药物治疗史进行回顾性调查。结果 逆转录酶区N236T单独突变组与逆转录酶区N236T+A181T联合突变组相比较,两者血清HBsAg水平的差异无统计学意义(P=0.975 5),但后者血清HBV DNA(P=0.001 4)和ALT(P=0.003 2)水平高于前者。此外,C型较B型容易发生rtN236T+rtA181T联合突变(40% vs 20.45%,P=0.023 5),由拉米夫定换用阿德福韦的治疗方式容易引起病毒突变。结论 HBV逆转录酶区N236T单独突变患者与逆转录酶区N236T+A181T联合突变患者在引起突变的核苷(酸)类药物的使用情况上存在一致性(拉米夫定换用阿德福韦),但基因型构成和血清病毒学指标存在明显差异。 |
| 关键词: 乙型肝炎病毒 逆转录酶区 突变 阿德福韦 |
| DOI：10.3724/SP.J.1008.2010.0834 |
| 投稿时间：2010-03-11修订日期：2010-04-28 |
| 基金项目: |
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| Patients with only N236T mutation and patients with N236T+A181T mutation in HBV reverse transcriptase region: a comparison of clinical characteristics |
| ZHAO Pan1,2, LI Xiao-dong2, LI Le2, ZHONG Yan-wei2,XU Dong-ping |
| (1. Academy of Military Medical Science, Beijing 100850, China; 2. Viral Hepatitis Research Laboratory, No. 302 Hospital of PLA, Beijing 100039, China) |
| Abstract: |
| Objective To compare the application of nucleotide drugs and the virology characteristics between patients with only N236T mutation and patients with N236T+A181T mutation in the HBV reverse transcriptase(rt) region. Methods Sera of patients with only rtN236T mutation and patients with rtN236T+rtA181T mutation were obtained from patients with chronic hepatitis B. Then the levels of sero-HBsAg, HBV DNA and ALT were determined and the HBV genotypes were analyzed. The treatment history with nucleotide drugs was retrospectively reviewed. Results The sero-HBsAg levels were not significantly different between only rtN236T mutation group and rtN236T+rtA181T mutation group (P=0.975 5), and significantly higher viral replication (P=0.001 4) and higher ALT level (P=0.003 2) were found in rtN236T+rtA181T mutation group. Moreover, compared to HBV B genotype, patients with HBV C genotype were prone to carry rtN236T+rtA181T mutation(40% vs 20.45%, P=0.023 5); also we noticed that a switch from lamivudine medication to adefovir medication was liable to induce the virus mutation. Conclusion Nucleotide drug application in HBV patients with only rtN236T mutation and rtN236T+rtA181T mutation are concurrent (lamivudine switching to adefovir). However, the HBV genotype constituents and the serum virological characteristics are different between the two types of HBV patients. |
| Key words: hepatitis B virus reverse transcriptase region mutation adefovir |
