HBV突变与HBV相关慢加急性肝衰竭相关性研究-论文.pdf

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1、74．传染病信息2014qZ0430日第27卷第2期InfectDisInfo，V。1·27，N。·2，April30,2014．————著·HBV突变与HBV相关慢加急性肝衰竭相关性研究张爱民，王慧芬，李桂英，李玉，段学章[摘要】目的探讨HBV突变与慢加急性肝衰竭(acute—on—chronicliverfailure，ACLF)之间的相关性。方法以87例HBV相关ACLF患者为研究对象，另选取52例慢性乙型肝炎(chronichepatitisB，CHB)患者和51例HBV肝硬化(1ivercirrhosis，Lc)患者为对照，应用聚合酶链反应及基因测序对患

2、者血清标本进行HBV基本核心启动子区、前C区和c区13个位点的突变检测，分析HBV突变与ACLF发生的相关性。结果CHB、LC、ACLF组人均核苷酸变异检出位点分别为2．31、3．55和3．86个。nt1762、nt1846、nt1899和nt19134个突变位点的核苷酸突变率比较，ACLF组高于CHB组；nt1764位点突变率组间比较Lc组高于ACLF组，而nt1846和ntl913位点突变率比较Lc组低于ACLF组；nt1753、nt1762、nt1764和nt18994个突变位点的核苷酸突变率比较，Lc组高于CHB组。多因素分析提示A1846T和C1913(

3、A／G)核苷酸突变是预测ACLF的有效指标。结论CHB或IC患者HBV基因序列的A1846T和C1913(A／G)核苷酸突变可能与其发生ACLF密切相关。[关键词】乙型肝炎病毒；肝功能衰竭，急性；乙型肝炎；突变率[中国图书资料分类号】R373．21；R575．3[文献标志码】A[文章编号]1007—8134(2014)02—0074—05AssociationbetweenHBVmutationsandHBV-relatedacute-on-chronicliverfailureZHANGAi—min，WANGHui—fen．LIGui—ying。LIYu。DUA

4、NXue—zhangCenterforTumorRadiationTherapy，302HospitalofPLA，Beijing100039，China*Correspondingauthor．E—mail：duanxuezhang@163．con[Abstract】ObjectiveToinvestigatetheassociationbetweenHBVmutationsandthedevelopmentofacute—on—chronicliverfailurefACLF)inpatientswithchronicHBVinfeetion．MetbodsA

5、totalof87HBV—relatedACLFfHBV—ACLF)patientswereenrolledinthestudy，and52age—andsex—matchedpatientswithchronichepatitisBfCHB1and51patientswithlivercirrhosis(LC1wereselectedascontrols．ThemutationsatHBVbasiccorepromoter，pre—core。andpattialCre~ionsweredeterminedbynest—edPCRanddirectsequenci

6、ngmethods．TheassociationbetweenHBVmutationsandthedevelopmentofACLFwasanalyzed．ResultsTheaveragenumbersofmutationsinCHB，LCandACLFgroupswere2．3l，3．55and3．86，respectively．AscomparedwithCHBgroup，ACLFgrouphadmoremutationsatnt1762，nt1846，nt1899andntl913；ascomparedwithLCgroup，ACLFhadfewermut

7、ationsatnt1764，andmoremutationsatntl846andntl913；ascomparedwithCHBgroupLCgrouphadmoremutationsatnt1753，nt1762，nt1764andntl899．MuhivariableanalysisindicatedthatA1846TandC1913(A／G1mutationswereindependentfac—torsforACLF．ConclusionHBVnucleotidemutationsofA1846TandC1913(A／G1maybecloselyas

8、socia