不同基因型HBV感染的慢性乙型肝炎患者临床与病理改变分析-内科学专业论文.docxVIP

PAGE PAGE 10 不同基因型 HBV 感染的慢性乙型肝炎 患者临床与病理改变研究 中 文 摘 要 目的：探讨不同基因类型的慢性乙型肝炎（CHB）患者在年龄、性别和 民族方面的内在关联，比较不同 HBV 基因型患者的肝组织病理损害程度的 差别、探讨慢性乙型肝炎患者肝组织改变与 HBV-DNA 载量及肝功能的相关 关系。方法：采用荧光定量 PCR 仪检测 94 例行肝活检的 CHB 患者的 HBV-DNA, 以实时荧光定量 PCR 鉴定 HBV 基因型。结果：本组 94 例 CHB 患者 B 基因型 占 74.5%，C 基因型占 25.5%。HBV 基因型与年龄、性别无关；C 基因型中壮 族中所占的比例明显高于 B 基因型；C 基因型患者 HBeAg 阳性率明显低于 B 基因型患者（P〈0.05）。CHB 患者肝组织病理损伤程度与 B、C 基因型相关， C 基因型在肝组织炎症及纤维化程度较重组所占的比例高于 B 基因型，差异 有统计学意义（P〈0.05）；肝组织病理损伤程度与肝功能指标相关，（P 〈0.05），但与 HBV-DNA 水平无关。结论：本组 CHB 患者 HBV 基因型呈 B、 C 两型，人群分布以 B 型为主，C 型次之，未见其他类型或混合型；汉族患 者以 B 基因型为主，壮族则以 C 型为主；B、C 基因型在年龄、性别上无差 异；相对于 B 基因型，C 基因型患者肝组织炎症及纤维化程度较重，容易出 现严重的肝损害和肝癌等不良预后。 关键词：肝炎病毒，乙型；基因型；民族；病理学，临床 Research clinical and pathological changes of chronic hepatitis B patients infected different HBV genotypes ABSTRACT Objective: To investigate the relationship of ages,genders and nationalities in different genotypes chronic hepatitis B (CHB) patients, to compare the differences between different HBV genotypes and hepatic tissue damage degree , to explore the relationship between liver tissue pathology、HBV DNA levels and liver function of the chronic hepatitis B patients. Methods: Fluorescence quantitative polymerase chain reaction (PCR) instrument is used to test HBV DNA and real-time fluorescence quantitative polymerase chain reaction is used to test HBV genotypes in 94 cases of patients with CHB done liver biopsy. Results: B genotype give priority to, 74.5%, C genotype accounted for 25.5% at the group contained 94 cases. CHB patients HBV genotype has nothing to do with age and sex. Zhuang in C genotype in the share of the ratio is significantly higher and in hepatitis e antigen (HBeAg) positive patients is obviously lower than B genotype (P 0.05). CHB patients liver tissue pathology with degree of damage related to genotype B and C. The proportion of C genotype in heavier liver tissue inflammation and fibrosis degree is higher than B genotype,the difference have statistical significance (P 0.05).Liver tissue