本文關(guān)鍵詞： 阿德福韋酯 肝炎病毒 乙型 耐藥 影響因素　出處：《青島大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：探討阿德福韋(阿德福韋酯,ADV)抗病毒治療對乙肝病毒(hepatitis B virus,HBV)感染病人發(fā)生基因型耐藥及其不同位點(diǎn)變異的影響。 方法：本研究應(yīng)用焦磷酸測序法,對83例服用ADV(包括拉米夫定序貫ADV)48周以上且出現(xiàn)病毒學(xué)突破的病人進(jìn)行基因耐藥檢測。同時檢測HBV DNA、HBsAg、 HBeAg、HBV基因型及肝功能相關(guān)指標(biāo)(ALT、AST、TBIL),行肝臟B超和CT檢查。 結(jié)果：(1)83例病毒學(xué)突破(VB)病例中,40例發(fā)生ADV.耐藥相關(guān)變異(變異組),43例未發(fā)生ADV耐藥相關(guān)變異(未變異組)；單因素分析后將兩組不同年齡段、ADV抗病毒療程、伴rtL180M變異納入多因素分析；Logistic回歸分析顯示,年齡40歲、ADV長療程治療、伴rtL180M變異是ADV耐藥相關(guān)位點(diǎn)變異的獨(dú)立危險因素(P均0.05)。(2)變異組中rtA181T變異14例,rtN236T變異12例,兩組AST、HBV基因型相比有統(tǒng)計(jì)學(xué)差別(P0.05),Logistic回歸分析顯示,B基因型發(fā)生rtN236T變異的可能性大(P=0.05)。 結(jié)論：(1)年齡40歲、ADV長療程治療、伴rtL180M變異的乙型肝炎患者更有可能發(fā)生ADV相關(guān)耐藥位點(diǎn)變異。(2)HBV B基因型較C基因型更有可能發(fā)生rtN236T變異。
[Abstract]:Objective: to investigate the effect of antiviral therapy of adefovir (ADV) on genotype resistance and variation of different loci in patients with hepatitis B virus infection. Methods: pyrosequencing was used in this study. Gene resistance was detected in 83 patients who took ADV (including lamivudine sequential ADV)48 for more than weeks and had virological breakthrough). HBV DNA HBsAg, HBeAgN HBV genotype and liver function related indexes were detected. Liver B ultrasound and CT were performed. Results among 83 cases of virological breakout, 40 cases developed ADV.Drug-resistance-related variation was found in 40 cases (43 cases in the variant group did not have the mutation group). After univariate analysis, the two groups were treated with anti-virus course of anti-ADV in different age groups. Logistic regression analysis showed that the age of 40 years old was 40 years old and the independent risk factor of ADV resistance-related locus mutation was rtL180M mutation (P < 0.05). There were 12 cases of rtA181T mutation in 14 cases of rtA181T mutation in the variant group, which was combined with multivariate analysis of multivariate analysis and logistic regression analysis (logistic regression analysis) showed that there were 12 cases of rtA181T mutation in the age of 40 years old. There was statistical difference between the two groups in the genotype of rtN236T. Logistic regression analysis showed that there was a great possibility of rtN236T variation in genotype B. ConclusionThe patients with rtL180M mutation were more likely to develop ADV related drug resistance locus variation than genotype C to develop rtN236T mutation in 40 years old patients with long course of treatment of ADV.ConclusionThe patients with rtL180M mutation were more likely to develop ADV related drug resistance locus variation.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R512.62

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本文編號：1499044