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[贵州四个城市乙肝病毒感染患者的病毒基因型调查]

[Investigation on virus genotype in patients infected with hepatitis B virus in four cities of Guizhou].

作者信息

Ding Jing juan, Zhang Quan, Peng Liang, Liu Yue-hui, Li Zhong, Liu San-du, Hu Lian

机构信息

Department of Infectious Diseases, Guiyang Medical College, Guiyang 550004, China.

出版信息

Zhonghua Liu Xing Bing Xue Za Zhi. 2006 Nov;27(11):977-80.

Abstract

OBJECTIVE

To investigate the distribution of hepatitis B virus (HBV) genotype in Guizhou and to study the relationship between the genotype and the progression of liver disease.

METHODS

786 patients with chronic HBV infection, from 4 cities of Guizhou, including 346 asymptomatic carriers (ASC), 313 chronic hepatitis (CH), 77 liver cirrhosis (LC), 50 hepatocellular carcinoma (HCC) were examined. HBV genotype was determined by restriction fragment length polymorphism analysis and the subtypes were determined by direct sequencing of PCR product in 94 patients with HBV B genotype, the relationship between HBV genotype and the progression of liver disease was studied by multifactor analysis such as HBeAg positivity, HBV DNA load and ALT level.

RESULTS

Of the 786 patients, 7 (0.89%), 497 (63.23%), 275 (34.99%), and 7 (0.89%) belonged to genotype A, B, C, D, respectively. There was statistically significant difference in the distribution of genotype B among Kaili (96.04%), Zunyi (78.79%), Duyun (64.52%) and Guiyang (53.14%) (P< 0.01). Genotype C was more prevalent in Guiyang than in other three cities (P < 0.01, or P < 0.05). Out of 94 genotypes B, 93 (98.94%) belonged to subtype Ba, only one was subtype Bj. There were statistically significant difference in the distribution of genotype B and C among various stage of liver disease (P < 0.05 or P < 0.01). Genotype B showed a gradual decrease from ASC, CH, LC to the HCC group while in contrast, genotype C showed a gradual increase in the same order. The ALT levels and the mean age were significantly higher and older in patients with genotype C than those in genotype B (P < 0.01 or 0.05). The HBeAg positivity was significantly lower in genotype C than that in genotype B (P < 0.025).

CONCLUSION

Data showed that there were genotype A, B, C and D existing in Guizhou. Genotype B was the major one but genotype C was more commonly seen. In genotype B, subtype Ba appeared to be predominant. The geographic distribution of genotype B and C were different in some cities of Guizhou. Compared to genotype B, genotype C was associated with the development of more severe liver damage.

摘要

目的

研究贵州地区乙型肝炎病毒(HBV)基因型分布情况,并探讨其与肝脏疾病进展的关系。

方法

对来自贵州4个城市的786例慢性HBV感染者进行检测,其中包括346例无症状携带者(ASC)、313例慢性肝炎(CH)、77例肝硬化(LC)、50例肝细胞癌(HCC)。采用限制性片段长度多态性分析确定HBV基因型,对94例B基因型患者的PCR产物进行直接测序确定亚型,通过多因素分析如HBeAg阳性、HBV DNA载量及ALT水平等研究HBV基因型与肝脏疾病进展的关系。

结果

786例患者中,分别有7例(0.89%)、497例(63.23%)、275例(34.99%)和7例(0.89%)属于A、B、C、D基因型。B基因型在凯里(96.04%)、遵义(78.79%)、都匀(64.52%)和贵阳(53.14%)的分布存在统计学差异(P<0.01)。C基因型在贵阳比其他三个城市更为常见(P<0.01或P<0.05)。94例B基因型中,93例(98.94%)属于Ba亚型,仅1例为Bj亚型。B和C基因型在不同肝病阶段的分布存在统计学差异(P<0.05或P<0.01)。B基因型从ASC、CH、LC到HCC组呈逐渐下降趋势,而C基因型则呈相反的逐渐上升趋势。C基因型患者的ALT水平和平均年龄显著高于B基因型患者(P<0.01或0.05)。C基因型的HBeAg阳性率显著低于B基因型(P<0.025)。

结论

数据表明贵州存在A、B、C和D基因型,B基因型为主,但C基因型更常见。在B基因型中,Ba亚型似乎占主导。B和C基因型在贵州部分城市的地理分布不同。与B基因型相比,C基因型与更严重的肝损伤发展相关。

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