摘要目的 探讨黑龙江省乙型肝炎病毒(HBV)拉米夫定耐药株YMDD变异与基因型、HBV BCP变异之间的相关性.方法 对收集的245例经拉米夫定治疗的慢性乙型肝炎患者血清标本,采用多重PCR法检测HBV的基因型；荧光标记杂交双探针PCR融解曲线法(FH-PCR-MC)检测HBV YMDD变异及变异类型；巢式PCR法扩增HBV C基因区,测序分析BCP位点变异并进行统计学分析.结果 在HBV YMDD野生株、变异株中,基因型B、C、B与C混合型分别为8.8％、89.2％、2.0％；6.3％、93％、0.7％,基因型构成比无统计学的差异.HBV BCP的变异率在YMDD野生株与变异株分别为69.6％、76.9％,无统计学的差异.在HBV YMDD野生株中,HBV B基因型BCP的变异率22.2％,C基因型BCP的变异率73.6％存在统计学差异(P＜0.01),但在YMDD变异株中,无统计学的差异.在YIDD、YVDD变异株HBV BCP变异率分别为83.0％和64.6％,存在统计学的差异(P＜0.05).结论 在HBV YMDD野生株中,与B基因型相比,C基因型更易发生BCP变异；YMDD变异株中,BCP变异率在B、C基因型间无统计学差异,BCP变异在变异类型间(YIDD、YVDD)存在统计学差异；与YVDD变异株相比较,YIDD变异株易发生HBV BCP的变异.

abstractsObjective To investigate the correlation between BCP mutations,genotypes and HBV Lamivudine-resistant YMDD mutation in Heilongjiang province. Methods The HBV DNA in 245 sera samples were collected from chronic hepatitis B patients who had been treated with lamivudine.HBV genotypes and YMDD mutations were detected by multiplex PCR and FH-PCR-MC respectively.HBV C gene region was amplified by nest PCR,then BCP mutations were analyzed.Results There were no statistical differences for the ratio of genotype between YMDD wild type(8.8％ with genotype B,89.2％ with genotype C and 2.0％ with B,C mixed genotype) and YMDD mutant type(6.3％ with genotype B,93.0％ with genotype C and 0.7％ with B,C mixed genotype).The ratio of BCP mutations in YMDD mutant type and YMDD wild type were 76.9％ and 69.6％ respectively and there were no statistical differences between them.In YMDD wild strains,BCP mutations occurred more frequently in genotype C than in genotype B ( P ＜ 0.01 ).While,in YMDD mutant type,there was no significant difference.The ratio of BCP mutations were 83.0％ and 64.6％ between YIDD and YVDD mutants,respectively,there were statistical differences between them (P ＜ 0.05).Conclusion There was a significant difference of the HBV BCP mutation with YMDD wild strains between the genotypes B and C.Mutation rate of the HBV BCP with YMDD mutants showed no significant difference between genotypes B and C.There was a significant difference of the HBV BCP mutation with YMDD mutants between the YIDD mutation type and YVDD mutation type.