乙型肝炎病毒感染临床结局及HLA-DR基因相关性探究.doc

乙型肝炎病毒感染临床结局及HLA-DR基因相关性探究[摘要] 目的：探讨乙型肝炎病毒（HBV）感染临床结局与人类白细胞抗原DR（HLA-DR）基因间的相关性。方法：选择急性乙型肝炎（AHB）76例，慢性乙型肝炎（CHB）102例，乙肝后肝硬化（LC）38例，肝细胞癌（HCC）34例，用聚合酶链反应-序列特异性引物法（PCR-SSP）检测HLA-DR基因型。结果：HLA-DR1基因型频率在LC和HCC组显著高于AHB组(χ2=8.495，P=0.004)，较CHB组也显著升高(χ2=5.667，P=0.017)；HLA-DR8基因型发生频率在CHB、LC和HCC三个HBV慢性感染组间无显著差异(P=0.034)，而在AHB组显著低于HBV慢性感染组(χ2=8.830，P=0.003)；HLA-DR13基因型频率在AHB组显著高于CHB组(χ2=26.876，P=0.000)及LC和HCC组(χ2=6.413，P=0.011)，而LC和HCC组又高于CHB组(χc2=6.479，Pc=0.011)。结论：HLA-DR1基因型可能与HBV相关的肝硬化和肝细胞癌的发生有关，而HLA-DR8基因型则对HBV感染的慢性化有促进作用，HLA-DR13基因型可有助于HBV的清除，但在HLA-DR13阳性的HBV慢性感染者发生肝硬化和肝细胞癌的风险增加。 [关键词] 乙型肝炎病毒；临床结局；人类白细胞抗原DR基因 [中图分类号] R512.6+2[文献标识码]C [文章编号]1673-7210（2008）11（b）-025－02 Study of the association between the clinical outcomes and HLA-DR genes in the hepatitis B virus infection subjects LIU Fu-hui1, LI Jian-zhong1, LI Chang-ying2, WANG Yi-cheng1 (1.Teaching Hospital of Medical College of Qingdao University, Qingdao Hospital for Infectious Diseases, Qingdao266033,China; 2.Qingdao Blood Center, Qingdao266071, China) [Abstract] Objective: To study the association between the clinical outcomes and HLA-DR genes in the hepatitis B virus infection subjects. Methods: HLA-DR alleles in 76 cases acute hepatitis B, 102 cases chronic hepatitis B, 38 cases liver cirrhosis and 34 hepatocellular carcinoma with HBV infection, were detected by polymerase chain reaction-sequence specific primer(PCR-SSP) technique. Results: The frequency of HLA-DR1 gene was significantly higher in liver cirrhosis and hepatocellular carcinoma group than that in acute hepatitis B (χ2=8.495，P=0.004) and that in chronic hepatitis B (χ2=5.667，P=0.017). There was no difference in the frequencies of HLA-DR8 gene among chronic hepatitis, liver cirrhosis and hepatocellular carcinoma groups(P=0.034), but the frequency in acute hepatitis B was significantly lower than that in the chronic HBV infection subjects(χ2=8.830，P=0.003). The frequency of HLA-DR13 gene was significantly higher in acute hepatitis B than