乙型肝炎病毒基本核心启动子T1762A1764 联合突变的临床意义

目的:研究乙型肝炎患者乙型肝炎病毒(HBV)基本核心启动子(BCP)T^1762A^1764联合突变情况及其临床意义。方法:采用聚合酶链反应(PCR)与限制性长度片段多态性分析(RFLP)相结合，检测130例乙型肝炎患者BCP区核苷酸(nt)1762碱基A→T和1764碱基G→A联合突变。结果：HBeAg( )和HBeAb( )两组患者中BCP T^1762A^1764联合突变率的不同频率分别为慢性乙型肝炎患者(Chronic hepatitis B，CHB)40．0％和85．7％，无症状携带者(Asymptomatic carrier，ASC)22．2％和65．0％，献血员为5％。BCP T^1762A^1764双点联合突变组HBV-DNA≥10^5 cps／ml检出例数81例(96．4％)，非突变组HBV-DNA≥10^5 cps／ml检出例数25例(54．3％)。结论：BCP T^1762A^1764联合突变与乙型肝炎的发生、发展以及预后有关，可能是CHB与ASC患者HBeAg(-)的原因之一，可促进乙肝病毒繁殖。对慢性乙型肝炎患者检测HBV BCP T^1762A^1764联合突变有一定的临床意义。

The Clinical Significance of the Basic Core Promoter T1762A1764Mutation of Hepatitis B Virus

Objective:To study the T 1762A 1764 mutation in the basic core promoter (BCP) region of hepatitis B (HBV) in Nantong viral hepatitis B patients. Methods:The BCP T 1762A 1764 mutations were detected by combining polymerase chain reaction (PCR) with restriction fragment length polymorphism (RFLP). Results: The BCP T 1762A 1764 mutation frequency in two groups HBeAg (+) and HBeAb (+) are 40.0% and 85.7% in CHB,22.2% and 65.0% in ASC, and 5% in donors.81(96.4%)in BCP mutant group and 25 (54.3%)in non-BCP mutant group were observed above 10 5 cps/ml in HBV DNA contents.Conclusions:There is a significant difference of BCP T 1762A 1764 mutation between patients and blood donors, which suggests that the BCP T 1762A 1764 mutation be one of the major causes for HBV infection in CHB and ASC patients with HBeAg (-), and that the mutation be revelant to the development, chronicity and fulmination of hepatitis B; A significant difference in HBV DNA content is also found between the T 1762A 1764 mutation group and non-mutation group,and the result suggests that the T 1762A 1764 mutation may accelerate the replication of HBV.