目的探讨慢性乙型肝炎患者中拉米夫定诱导的 YMDD 变异和前 C 区1896位核苷酸以及 C区启动子1762和1764位核苷酸变异的检出率及其临床意义。方法采用基因芯片技术检测拉米夫定治疗6个月以上的122例慢性乙型肝炎患者血清中前 C 区1896位以及 C 区启动子1762和1764位核苷酸变异发生率。结果 122俐慢性乙型肝炎患者中检出40例 YMDD 变异阳性患者,检出率为32.8%。发生 YMDD变异后,HBV DNA 反跳,ALT 和 AST 增高,差异有统计学意义(P<0.01)。YMDD 变异阳性患者前 C 区1896位和 C 区启动子1762和1764位核苷酸变异检出率显著高于无 YMDD 变异的慢性乙型肝炎患者,差异有统计学意义(P<0.01)。YMDD 变异阳性伴前 C 区1896位以及 C 区启动子1762和1764位核苷酸变异患者与无前 C 区1896位以及 C 区启动于1762和1764位核苷酸变异的 YMDD 变异阳性患者比较,病情容易加重.易发展为重型肝炎或肝硬化,但差异无统计学意义(P>0.05)。结论拉米夫定诱导的 YMDD 变异患者容易发生前 C 区1896位/C 区启动子1762和1764位核菅酸变异,但与病情加重和预后无相关性。
To investigate the k inetics of antibody to SARS coronavirus in SARS patients and its clinical implication,ELISA was used to dete ct antibody to SARS coronavirus(SA RS CoV),RT-PCR was used to detect the SARS CoV RNA and,besides,the C D+4 and CD+8 T cells in peripheral blood of SARS patients and healthy controls were assayed by flowcytom etryThe results showed that SARS CoV IgM were first detected from da y 7 to day 47 after SARS onset,wit h average at day 193±101SARS Co V IgG were first detected from day 4 to day 47 after SARS onset,with average at day 207±101,and the p roduction of SARS CoV IgG was corr elated with CD+4 T cell number(P<005),but had no relationship with SARS CoV RNAMost SARS patients pr oduced SARS CoV antibody,IgM produ ced almost at the same time wit h IgGSARS CoV IgG is a protective antibody against SARS CoV and the titer of IgG may be used as an ind ex indicating the specific immunit y production in SARS
