目的 探讨拉米夫定(lam)耐药hbv多聚酶基因区基因突变的分布及其与病毒载量之间的关系.方法 采用pcr方法对74例lam耐药患者血清hbv多聚酶基因区进行扩增,对pcr产物进行直接测序并检测病毒载量情况.通过描述性统计及多元统计分析hbv耐药基因突变情况及与病毒载量情况.结果 74例hbv感染者多聚酶基因区基因突变类型有7种,其中以rtm204v/rtl180m、rtm204i和rtm204i/rtl180m最为多见.hbv多聚酶基因区基因突变位点主要为rtm204i(38.7%)、rtm204v(21.8%)、rtl180m(38.7%)和rtv173l(0.8%).结论 lam耐药突变位点和类型复杂多样,常见hbv基因耐药位点及类型与病毒载量之间无直接相关性,但可能存在少数位点突变类型与病毒载量相关.
abstract：
objective to investigate mutations at hbv p gene rt region in lamivudine-resistant patients. methods serum samples were collected from 74 hepatitis b patients resistant to lamivudine. hbv p gene rt region was amplified by pcr, and the pcr products were directly sequenced and the viral loads were detected. results there were 7 forms of mutations in 74 patients harboring ymdd mutations detected in this study. the common mutation forms were rtm204v/rtl180m, rtm204i and rtm204i/rtl180m. the most frequent mutation positions were rtm204i (38.7%), rtm204v (21.8%), rtl180m (38.7%) and rtv173l (0.8%). conclusions the mutation forms and positions of lamivudine-resistant viral strains are complex. common mutation forms and positions are not directly correlated with the viral load, but some novel forms may be associated with it.
