慢性乙肝YMDD变异患者肝纤维化指标、血清标志物的检测及意义

王瑜敏; 陶志华; 朱燕英; 林晓梅

慢性乙肝YMDD变异患者肝纤维化指标、血清标志物的检测及意义

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中图分类号: R512.6
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出版历程
- 出版日期: 2007-03-20

Detecting of the hepatic fibrotic indexes and serous markers from patients with chronic hepatitis B (CHB) and variation of HBV DNA YMDD

摘要

摘要: 探讨慢性乙肝患者（CHB）发生YMDD变异后肝纤维化指标及血清标志物的变化意义。检测接受拉米夫定治疗285例CHB患者YMDD变异情况,根据结果分为无突变组和突变组;又各分为继续使用拉米夫定治疗组和未继续治疗组;并测定各组乙肝病毒拷贝数（HBV-DNA）、乙肝两对半（HBV M）、常规肝功能指标、透明质酸（HA）、Ⅲ型前胶原（PCⅢ）、Ⅳ型胶原（C IV）水平。结果显示285例患者中发生YMDD突变144例,以Y IDD型最常见;突变组HBeAg阳性率、HBV-DNA水平高于无突变组（P<0.01、P<0.05）;无突变病例中继续治疗组C IV、PCⅢ、HBV-DNA水平比未继续治疗组出现下降（P<0.01、P<0.05）。YMDD突变组HBeAg阳性率、病毒拷贝数高于无突变组,而纤维化指标无差异;继续使用拉米夫定治疗,可改善无突变组患者肝组织纤维化。
- 慢性乙肝 /
- YMDD变异 /
- 肝纤维化,血清乙肝标志物
Abstract: To Study variation and clinical significance of the hepatic fibrotic indexes and serous markers form patients with chronic hepatitis B (CHB) and variation of HBV DNA YMDD.The 285 patients with the diagnose of CHB were detected for YMDD mutation.According to the results, the cases were divided into mutation group and nonmutation group.Moreover, they were further separated into therapy group treated with lamivudine and control group.HBV-DNA, HBV M, ALT, AST, GGT, HA, PCⅢ and CⅣ were studied.The HBV DNA YMDD sequence of 144 cases mutated compared with the control group.The HBeAg positive rate and the level of HBV DNA of mutation group were higher than those of nonmutation group (P<0.01, P<0.05) .While the PⅣ、PCⅢ、HBV DNA of therapy group from the YMDD nonmutation cases decreased evidently.The HBeAg positive rate and HBV DNA were probably related to the YMDD mutation.The use of lamivudine might ameliorate fibrosis of the hepatic tissue form nonmutation cases.
- chronic hepatitis B /
- YMDD mutation /
- hepatic fibrotic indexes

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参考文献(8)

[1]顾生旺, 张泓, 章廉, 等.肝组织纤维化分期的纤维定量分析与血清肝纤维化标志物关系的研究[J].中华肝病杂志, 1999, 7 (4) ∶199-200.

[2]陈伟, 邓少丽, 陈迎春.拉米夫定治疗后乙肝病毒发生YMDD变异的研究[J].重庆医学, 2003, 32 (12) ∶1617-1618.

[3]闫杰, 王磊, 徐皖苏, 等.拉米夫定治疗中乙肝病毒多聚酶YMDD变异对患者临床经过的影响[J].山东医科大学学报, 2001, 39 (2) ∶171-172.

[4] 康格非, 巫向前.临床生物化学和生物化学检验学[M].第2版.北京:人民卫生出版社, 1998∶255-256.

[5]Melegari M, Scaglioni PP, Wands JR.Hepatitis B virus mutant asso-ciated with 3TC and famciclovir administration are replication defec-tive[J].Hepatiology, 1998, 27∶628-633.

[6]Kweon Yo, Goodman ZD, Dienstag JL, et al.Decreasing fibrogene-sis:an immunohistochemical study of paired liver biopsies followinglamivudine therapy for chronic hepatitis B[J].J Hepatol, 2001, 35 (6) ∶749-55.

[7] Lai CL, Chien RN, Leung NW, et al.Aone-year trial of lamivudi-ne for chronic hepatitis B.Asia Hepatitis Lamivudine Study Group[J].N Engl J Med, 1998, 339 (2) ∶61-8.

[8]Liaw YF, Leung NW, Chang TT, et al.Effects of extended lamivu-dine therapy in Asian patients with the chronic hepatitis B[J].Gas-troenterology, 2000, 119∶172-180.

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