拉米夫定耐药HBV毒株伴随变异与YMDD变异的关系邵幼林，赵卫峰，陈良云，朱义玲，甘建和邵幼林，赵卫峰，陈良云，朱义玲，甘建和，苏州大学附属第一医院感染科江苏省苏州市215006邵幼林，男，1982-06-17生，江西鄱阳县人，汉族．2006年苏州大学附属第一医院感染科硕士研究生主要从事病毒性肝炎的研究．基金项目：江苏省卫生科研项目（NO.H200711）通讯作者：赵卫峰，215006，江苏省苏州市十梓街96号，苏州大学附属第一医院感染科，HYPERLINK"mailto:szzhaoweifeng@yahoo.com.cn"szzhaoweifeng@yahoo.com.cn电话：13306218767收稿日期：接受日期：TherelationshipsofincidentalmutationsandYMDDmutationofthereversetranscriptasedomainofHBVpolymeraseinlamivudine-resistantpatientsYou-linShao,Wei-fengZhao,Liang-yunChen,Yi-lingZhu,Jian-heGanYou-linShao,Wei-fengZhao,Liang-yunChen,Yi-lingZhu,Jian-heGan.DepartmentofinfectiousDiseasea.FirstAffiliatedHospitalofSoochowUniversity,Suzhou,JiangsuProvince,215006,China.SupportedbytheFundofhealthprojectofJiangsuProvince,No.H200711Correspondenceto:Wei-fengZhaoDepartmentofinfectiousDiseasea.FirstAffiliatedHospitalofSoochowUniversity,Suzhou,JiangsuProvince,215006,China.Email:szzhaoweifeng@yahoo.com.cnReceived:Accepted:AbstractAimTostudytheincidentalmutationsandtherelationshipsofthemwithtyrosine-methionine-aspartate-aspartate(YMDD)mutationofthereversetranscription（RT）domainofHBVpolymeraseinlamivudine-resistant(LAMr)patients.MethodsHBVDNAwasamplifiedbyPCRusingspecificprimersflankingregionsofRTandthePCRproductsweredirectlyanalyzedbysequencing.HBVDNAlevelswithmutationsofLAMrweremeasuredviareal-timePCR.HBVDNAlevelswereanalyzedaccordingtopatternsofthemutationsofLAMr(group1withrtV173L/MorrtV207M/L/Imutations,group2withrtS213Tmutationandgroup3withoutthethreemutations).Results1)TheleadingmutationisYMDDmutationandtheincidentalmutationsarertL180M,rtV173L/M,rtV207M/L/IandrtS213Tmutations.ThereisnodifferenceoftheconstituentratioofmutationsbetweengenotypeBandC(P=0.2620).2)Theincidentalmutationsexistin38.8%rtM204I,89.2%rtM204V,73.3%rtM204V/Irespectively(P<0.0001).3)TheserumHBVDNAlevelofgroup1,2and3was7.43±0.16log10copies/ml,5.01±0.90log10copies/ml,5.75±0.34log10copies/mlrespectivly(F=4.48，P=0.0240).ConclusionThereisnodifferenceoftheconstituentratioofmutationsbet