目的 研究HCV基因型的分布,以探讨不同基因型感染者血清HCV RNA载量的差异.方法 采用PCR法检测218例慢性丙型肝炎患者血清HCV RNA;采用ELISA法检测抗-HCV抗体;使用全自动生化分析仪测定丙氨酸氨基转移酶;采用化学发光免疫分析法测定血清肝纤维化指标;采用基因芯片法进行HCV基因分型.结果 在218例HCV RNA阳性血清中共检出9种基因型,分别是lb、2a、3a、3b、6型单基因型共208例和lb +2a、lb +3b、lb+6型、2a+3a共10例四种混合基因型,其中以lb型168例(77.1%)、2a型19例(8.7%)为主;在208例HCV单基因型感染患者中发现不同基因型感染者血清HCV RNA载量无统计学差异(F=0.932,P>0.05);在168例1b基因型和40例非lb基因型感染者,性别差异无统计学意义(x2=0.857,P>0.05),两型感染者之间肝纤维化指标差别比较也无统计学意义.结论 我国HCV基因型以lb型为主,基因型与HCV RNA载量及ALT水平之间无相关性.%Objective To determine the distribution of hepatitis C virus genotypes in patients with chronic hepatitis C, and to study the serum HCV RNA levels in patients with different HCV genotype infection. Methods The levels of serum HCV RNA was measured with real -time fluorescent quantitative reverse -transcription polymerase chain reaction,the serum anti -HCV was detected by ELISA,ALT by automatic biochemistry analyzer, the levels of hyaluronic acid, laminin, procollagen type M N-terminal peptide and collage type IV were detectd by chemiluminescence iummunoassay and the HCV genotypes in 218 patients with chronic hepatitis C were determined by gene chip. Results There were nine different subgenotypes of HCV in 218 samples, including genotype lb,2a,3a,3b and 6 genotype in 208 sera and lb+2a, lb+3b, lb+6,2a+3a in other 10 sera, respectively; Genotype lb was the main one (77.1%, 168/218) , and the genotype 2a was the second (8.7%, 19/ 218); There was no significant difference between the serum HCV RNA levels in 208 patients with different HCV genotype infection (F =0.932, P>0.05); There was no significant difference between HCV genotype and gender as well as the levels of four blood markers of hepatic fibrosis in 168 patients with lb and 40 with non-genotype lb infection (x2=0.857,P>0.05). Conclusions HCV lb is the main prevalent genotype in patients with chronic hepatitis C, and the serum level of HCV RNA is not related to HCV genotype infection.
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