江苏部分地区HBV感染人群天然耐药及抗病毒药物临床疗效的相关因素分析

发布时间：2018-06-04 12:10

本文选题：乙型肝炎 + 基因耐药　；参考：《南京医科大学》2014年硕士论文

【摘要】：第一部分江苏部分地区慢性HBV感染者天然耐药的调查中文摘要目的： HBV在药物作用压力下可诱发药物相关的耐药,但近来有报道未使用抗病毒药物的HBV感染者有预存耐药即天然耐药。本研究通过连续监测江苏部分地区HBV感染者发生天然耐药基因变异的频度及耐药位点的分布特点,为合理选择抗病毒治疗的药物提供依据。方法： 1.回顾性分析2004-2010年未服用核苷类似物抗病毒药物的352例慢性乙型肝炎(CHB)患者临床资料。 2.应用焦磷酸测序技术及双脱氧链终止法(Sanger)基因测序的方法进行耐药基因的检测。结果： 1.352例CHB患者,345例基因测序成功,7例测序失败。8例有耐药基因突变,天然耐药突变检出率为2.32%。 2.主要耐药位点为rtV173L、rtL180M、rtA181T、rtM204V、rtV207L、rtS213T、 rtV2141、rtN236T。 3.2004-2006年间145例CHB患者均未检测出耐药突变,2007、2008、2009及2010年耐药突变的检出率分别为2.63%、3.92%、4.69%和4%。 4.多因素logistic回归分析显示耐药突变的发生与感染者年龄及地区来源相关。结论： 1.江苏部分地区CHB患者有天然耐药基因突变,耐药突变检出率为2.32%。 2.2004-2010年耐药突变检出率呈上升趋势。 3.患者地区来源及年龄超过30岁是耐药突变发生的相关因素。
[Abstract]:Part I investigation of natural drug resistance of chronic HBV infected persons in some parts of Jiangsu Province Chinese abstract Objective: HBV can induce drug-related drug resistance under the action of drugs, but it has been reported recently that HBV infected people who do not use antiviral drugs have preexisting drug resistance, that is, natural drug resistance. In this study, we continuously monitored the frequency of natural drug resistance gene mutation and the distribution of drug resistance sites among HBV infected people in Jiangsu province, which provided a basis for the rational selection of antiviral drugs. Methods: 1. The clinical data of 352 patients with chronic hepatitis B (CHB) who did not take nucleoside analogue antiviral drugs from 2004 to 2010 were analyzed retrospectively. 2. Pyrosequencing and dideoxy chain termination were used to detect drug-resistant genes. Results: 1.352 cases of CHB patients were successfully sequenced and 7 cases failed to sequence. 8 cases had drug resistance gene mutation, and the detection rate of natural drug resistance mutation was 2.32%. 2. The main drug resistance sites were rtV173L, rtL180MnltA181TnrtM204V, rtV207L, rtS213T, rtV2141and rtN236T, respectively. 3. From 2004 to 2006, the positive rates of drug-resistant mutation in 145 patients with CHB were 2.633.92% and 4.69%, respectively, and 4.69% in 2009 and 2010, respectively. 4. Multivariate logistic regression analysis showed that the occurrence of drug resistance mutation was related to the age and source of infection. Conclusion: 1. Natural drug resistance gene mutation was found in some CHB patients in Jiangsu province, and the detection rate of drug resistance mutation was 2.32. 2. The detection rate of drug resistance mutation increased from 2004 to 2010. 3. The origin and age of patients over 30 years are the related factors of drug resistance mutation.
【学位授予单位】：南京医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R512.62

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