老年慢性乙型肝炎患者基因多态性与其耐药变异的相关性

发布时间：2018-01-22 12:11

本文关键词： 慢性乙型肝炎基因多态性耐药变异　出处：《中国老年学杂志》2017年02期 　论文类型：期刊论文

【摘要】：目的研究老年慢性乙型肝炎患者基因多态性与其耐药变异的相关性。方法选取接受抗病毒治疗的老年慢性乙型肝炎患者188例。检测患者在使用不同核苷类抗病毒药物后血清样本,进行基因测序和分型。结果 C基因型占比显著高于B基因型、D基因型;且B基因型占比高于D基因型(均P0.05)。C基因型YIDD突变占比显著高于B基因型(χ2=7.918,P=0.005),而B基因型的YVDD突变高于C基因型(χ2=8.965,P=0.000)。B基因型与YVDD突变存在显著正相关(r=0.783,P=0.000),同样C基因型与YIDD突变存在显著正相关(r=0.819,P=0.000)。单一耐药中阿德夫韦耐药率显著高于拉米夫定与恩替卡韦,在共同耐药中拉米夫定+阿德夫韦+替米夫定共同耐药率显著高于拉米夫定+阿德夫韦+替米夫定+恩替卡韦、拉米夫定+阿德夫韦、拉米夫定+替米夫定以及拉米夫定+恩替卡韦。阿德夫韦、拉米夫定+阿德夫韦+替米夫定耐药均与B基因型YIDD突变、C基因型YVDD突变显著正相关(r=0.748,P=0.000;r=0.583,P=0.000;r=0.673,P=0.000;r=0.617,P=0.000)。结论乙型肝炎病毒(HBV)基因型中B基因型与YVDD突变、C基因型与YIDD突变均正相关,阿德夫韦、拉米夫定+阿德夫韦+替米夫定耐药与B基因型YIDD突变、C基因型YVDD突变正相关。通过对HBV基因分型以及耐药位点的检测,对临床及时调整用药方案有一定帮助。
[Abstract]:Objective to study the relationship between gene polymorphism and drug resistance variation in elderly patients with chronic hepatitis B. methods 188 elderly patients with chronic hepatitis B received antiviral therapy. A serum sample after a viral drug. Results the percentage of genotype C was significantly higher than that of genotype B and genotype D; The ratio of genotype B to genotype D was higher than that of genotype D (P 0.05). The percentage of YIDD mutation in genotype C was significantly higher than that in genotype B (蠂 2 7.918). The YVDD mutation of genotype B was higher than that of genotype C (蠂 2 / 8.965). There was a significant positive correlation between genotype B and YVDD mutation. There was a significant positive correlation between genotype C and YIDD mutation. The resistance rate of adefovir in single drug resistance was significantly higher than that of lamivudine and entecavir. The common resistance rate of lamivudine adefovir timivudine was significantly higher than that of lamivudine entecavir and lamivudine adefovir. Lamivudine telmivudine, lamivudine entikavir, lamivudine, lamivudine, telmivudine resistance were all associated with genotype B YIDD mutation. The YVDD mutation of genotype C was positively correlated with 0.748Pu 0.000; Rhizoma Rhizoma 0.583Pu 0.000; Rhizoma 0.673Pu 0.000; Conclusion there is a positive correlation between genotype B and YVDD mutation C and YIDD mutation. Lamivudine adefovitimidine resistance was positively correlated with genotype B YIDD mutation and genotype C YVDD mutation. HBV genotyping and drug resistance loci were detected. It is helpful to adjust the medication scheme in time.
【作者单位】：兰州大学第一医院传染科;兰州大学第一医院东岗院区传染科;兰州大学第一临床医学院;
【分类号】：R512.62
【正文快照】： 1兰州大学第一医院东岗院区传染科2兰州大学第一临床医学院乙型肝炎病毒(HBV)是引发病毒性肝炎、肝硬化以及肝癌的主要因素〔1,2〕。目前临床上应用较为广泛的抗HBV药物包括拉米夫定、阿德夫韦以及恩替卡韦等。上述抗病毒药物的应用可有效降低HBV感染风险,但长期使用会导致耐

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