郑昕 杨东亮 唐振亚 赵西平 李岱 郝连杰 430030,武汉,同济医科大学附属同济医院临床免疫室. 中华肝脏病杂志 1999 0 7 1


    关键词：乙型肝炎病毒 突变 病理学 治疗 期刊 zhgzbzz 0 临床研究 fur -->


    

摘要 目的 探讨乙型肝炎病毒(HBV)前C区突变株(1896位点G→A点突变)慢性感染患者的临床特点、病理特征及与干扰素疗效的关系。方法 采用突变特异性PCR检测108份慢性HBV感染患者血清和/或肝组织中HBV前C区突变株，按Knodell方法评价肝组织病理损伤。结果 HBV前C区突变株在不同e系统均存在，但HBeAb(+)组中单纯突变株感染或突变株感染占优势的混合感染(14.29%，46.23%)显著地高于HBeAg(+)组(0%,6.45%)；突变株感染与肝脏疾病严重程度相关，慢性肝炎重度组检出率(13.64%，40.91%)极显著地高于慢性无症状携带者(0%,10.26%)。5例前C区突变株感染者应用干扰素治疗可产生应答和无应答2种结果。临床症状较轻的HBV前C区突变株感染者的肝脏病理损伤程度无明显加重。结论 前C区突变株感染普遍存在，但更常见于HBeAb阳性者。

    

The clinical and pathology study ofHBV precore mutant infection in chronic HBV patients

ZHENG Xin,YANG Dongliang,TANG Zhenya,etal.

Clinical Immunology ResearchUnit,Tongji Hospital of Tongji Medical University,Wuhan 430030

Abstract Objective Toelucidate the clinical feature,pathological change and IFN therapy of HBV pre-c mutant(1896 G→A point mutation).Methods Mutation specific PCR was employed fordetecting precore mutation from 108 serum and/or liver samples of patients with chronichepatitis B infection.Liver damage was evaluated with Knodell's histology activity index(HAI) in 46 patients.Results HBV precore mutant existed popularly indifferent e systems status,but the detective rate of HBV precore mutant or mutantprevailing over wild type in HBeAb+ group(14.29%,46.23%) was signifcantly higher than thatin HBeAg+(0%,6.45%)group.Mutant infection was associated with the severity of liverdiseases,the detective rate in severe chronic hepatitis group was significantlyhigher(13.64%,40.91%) than that in chronic asympotamatic carriers groupe(0%,15.62%).5precore mutant positive patients with IFN treatment showed either response or nonresponseto IFN therapy.There was no significant difference of liver pathological change betweenmutant type and wild type infection in patients with mild chronic hepatitis.Conclusion HBV precore mutant infection existed commonly in patients with chronic hepatitis B,despiteof the e system status,though it was more prevalent in patients with HBeAbpositive.Further study is needed in the pathogenicity and the treatment of HBV precoremutation.

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