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目的调研重庆地区乙型肝炎病毒(hepatitis B virus, HBV)基因型构成,探讨HBV基因型与乙型肝炎疾病进程的相关性。方法用SSP-PCR法对360例HBV DNA阳性患者HBV基因分型,采用多因素Logistic回归分析HBV基因型与疾病表型的相关性。结果本回顾性研究人群中,HBV-B型占45.6%,HBV-C型占53.9%,分型失败0.5%。随着疾病从慢性乙型肝炎到肝硬化、原发性肝细胞癌的进展,C型HBV所占比例显著上升(χ2=23.368,P<0.001)。Logistic回归分析显示HBV基因型是HBV感染者罹患肝癌的独立风险因素(OR=3.2,P=0.01)。B、C基因型患者的HBV DNA水平和HBeAg阳性率无显著差异(P>0.05)。结论重庆地区HBV基因型以B、C型为主,C型HBV更易导致严重的肝病,HBV基因型是影响疾病进程的重要因素。
Objective To investigate the genotypes of hepatitis B virus (HBV) in Chongqing and explore the relationship between HBV genotypes and the progression of hepatitis B diseases. Methods HBV genotypes were determined by SSP-PCR in 360 HBV DNA positive patients. Multivariate Logistic regression was used to analyze the association between HBV genotype and disease phenotype. Results In this retrospective study population, HBV-B accounted for 45.6%, HBV-C accounted for 53.9%, and typing failed 0.5%. As the disease progressed from chronic hepatitis B to cirrhosis and primary hepatocellular carcinoma, the proportion of type C HBV increased significantly (χ2 = 23.368, P <0.001). Logistic regression analysis showed that HBV genotype was an independent risk factor for HCC in patients with HBV infection (OR = 3.2, P = 0.01). HBV DNA levels and HBeAg positive rates in patients with genotype B and C were not significantly different (P> 0.05). Conclusion HBV genotypes in Chongqing are mainly B and C. HBV genotype C is more likely to cause severe liver disease. HBV genotype is an important factor affecting the disease process.