本文選題：乙型肝炎 + 基因耐藥��； 參考：《南京醫(yī)科大學(xué)》2014年碩士論文

【摘要】：第一部分江蘇部分地區(qū)慢性HBV感染者天然耐藥的調(diào)查 中文摘要 目的： HBV在藥物作用壓力下可誘發(fā)藥物相關(guān)的耐藥,但近來有報(bào)道未使用抗病毒藥物的HBV感染者有預(yù)存耐藥即天然耐藥。本研究通過連續(xù)監(jiān)測(cè)江蘇部分地區(qū)HBV感染者發(fā)生天然耐藥基因變異的頻度及耐藥位點(diǎn)的分布特點(diǎn),為合理選擇抗病毒治療的藥物提供依據(jù)。 方法： 1.回顧性分析2004-2010年未服用核苷類似物抗病毒藥物的352例慢性乙型肝炎(CHB)患者臨床資料。 2.應(yīng)用焦磷酸測(cè)序技術(shù)及雙脫氧鏈終止法(Sanger)基因測(cè)序的方法進(jìn)行耐藥基因的檢測(cè)。 結(jié)果： 1.352例CHB患者,345例基因測(cè)序成功,7例測(cè)序失敗。8例有耐藥基因突變,天然耐藥突變檢出率為2.32%。 2.主要耐藥位點(diǎn)為rtV173L、rtL180M、rtA181T、rtM204V、rtV207L、rtS213T、 rtV2141、rtN236T。 3.2004-2006年間145例CHB患者均未檢測(cè)出耐藥突變,2007、2008、2009及2010年耐藥突變的檢出率分別為2.63%、3.92%、4.69%和4%。 4.多因素logistic回歸分析顯示耐藥突變的發(fā)生與感染者年齡及地區(qū)來源相關(guān)。 結(jié)論： 1.江蘇部分地區(qū)CHB患者有天然耐藥基因突變,耐藥突變檢出率為2.32%。 2.2004-2010年耐藥突變檢出率呈上升趨勢(shì)。 3.患者地區(qū)來源及年齡超過30歲是耐藥突變發(fā)生的相關(guān)因素。
[Abstract]:Part I investigation of natural drug resistance of chronic HBV infected persons in some parts of Jiangsu Province Chinese abstract Objective: HBV can induce drug-related drug resistance under the action of drugs, but it has been reported recently that HBV infected people who do not use antiviral drugs have preexisting drug resistance, that is, natural drug resistance. In this study, we continuously monitored the frequency of natural drug resistance gene mutation and the distribution of drug resistance sites among HBV infected people in Jiangsu province, which provided a basis for the rational selection of antiviral drugs. Methods: 1. The clinical data of 352 patients with chronic hepatitis B (CHB) who did not take nucleoside analogue antiviral drugs from 2004 to 2010 were analyzed retrospectively. 2. Pyrosequencing and dideoxy chain termination were used to detect drug-resistant genes. Results: 1.352 cases of CHB patients were successfully sequenced and 7 cases failed to sequence. 8 cases had drug resistance gene mutation, and the detection rate of natural drug resistance mutation was 2.32%. 2. The main drug resistance sites were rtV173L, rtL180MnltA181TnrtM204V, rtV207L, rtS213T, rtV2141and rtN236T, respectively. 3. From 2004 to 2006, the positive rates of drug-resistant mutation in 145 patients with CHB were 2.633.92% and 4.69%, respectively, and 4.69% in 2009 and 2010, respectively. 4. Multivariate logistic regression analysis showed that the occurrence of drug resistance mutation was related to the age and source of infection. Conclusion: 1. Natural drug resistance gene mutation was found in some CHB patients in Jiangsu province, and the detection rate of drug resistance mutation was 2.32. 2. The detection rate of drug resistance mutation increased from 2004 to 2010. 3. The origin and age of patients over 30 years are the related factors of drug resistance mutation.
【學(xué)位授予單位】：南京醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R512.62

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本文編號(hào)：1977308