乙型肝炎病毒新基因型 I与肝脏疾病关系的研究

摘要

Objective To explore the relationship between new genotype I of hepatitis B virus ( HBV) and liver diseases ,and to provide the scientific basis for the prevention of hepatitis B .Methods According to the principle of case-control study ,the serum samples of 97 chronic hepatitis B patients ,72 cirrhosis patients ,104 primary liver cancer patients and 117 asymptomatic HBV carriers were collected for HBV DNA amplification and sequence analysis by using nested polymerase chain reaction ( nested PCR) .STAR software and NCBI genotyping tools were used to perform genotyping . The relative proportions in all kinds of liver diseases in the new genotype I of HBV and other genotypes were analyzed . Results A total of 390 samples were collected .HBV genotype I accounted for 5.90%,genotype A accounted for 0.77%, genotype B accounted for 32.05%,genotype C accounted for 61.03%,genotype G accounted for 0.26%.There was no significant difference in the distribution of HBV genotype I in asymptomatic HBV carriers , chronic hepatitis patients , cirrhosis patients,primary liver cancer patients (P>0.05).There was no significant difference in ALT and detection rate of abnormal cases between genotype I and other genotypes ( P>0 .05 ) .The high viral loads of genotype I ,C were higher than that of genotype B ( P<0 .01 ) .The detection rate of genotype B in HBV asymptomatic carriers , chronic hepatitis patients ,liver cirrhosis patients and primary liver cancer patients decreased ( P<0 .01 ) while the detection rate of genotype C showed an increasing trend ( P<0 .01 ) .The risk of genotype I in chronic hepatitis patients , liver cirrhosis patients ,primary liver cancer patients was higher than that of genotype B ,and the risk of genotype C in liver cirrhosis patients ,primary liver cancer patients was higher than that of genotype B .Conclusion The new genotype I of HBV is related with liver diseases;Genotype C is related with liver cirrhosis ,primary liver cancer .%目的：了解乙型肝炎病毒（ HBV）新基因型I与肝脏疾病的关系，为乙肝防治提供科学依据。方法按病例对照研究的原理，采集97例慢性乙型肝炎、72例肝硬化、104例原发性肝癌患者和117例HBV无症状携带者血清标本，用套式聚合酶链反应进行HBV DNA扩增和序列分析。用STAR软件和NCBI基因分型工具进行基因分型，分析HBV新基因型I及其他基因型在各类肝脏疾病中的比例。结果共采集标本390份，HBV基因型I占5．90％，基因型A占0．77％，基因型B占32．05％，基因型C占61．03％，基因型G占0．26％；HBV基因型I在HBV无症状携带者、慢性肝炎、肝硬化、原发性肝癌组中比例比较差异无统计学意义（P＞0．05）。基因型I的丙氨酸氨基转移酶、异常检出率与其他基因型比较差异无统计学意义（P＞0．05），基因型I、C高病毒量率均高于基因型B （P＜0．01）。基因型B在HBV无症状携带者、慢性肝炎、肝硬化、原发性肝癌的检出率呈减少趋势（P＜0．01）；基因型C的检出率则呈增加趋势（P＜0．01）。基因型I在慢性肝炎、肝硬化、原发性肝癌的危险度均高于基因型B，基因型C在肝硬化、原发性肝癌的危险度均高于基因型B。结论 HBV 新基因型I 与肝脏疾病有关；基因型C 与肝硬化、原发性肝癌的发生有关。