中文摘要：

目的：研究慢性乙型肝炎患者前C/C区突变位点与肝脏疾病进展的临床意义。方法应用实时荧光定量PCR及直接测序法检测HBeAg阴性慢性乙型肝炎30例、HBeAg阳性慢性乙型肝炎20例，分析前C/C区变异位点与患者病情进展的相关性。结果肝硬化组前C/C区变异位点T1762/A1764、A1896发生率（86.3％，54.5％）明显高于慢性肝炎组（32.1％，35.7％），差异均有统计学意义（ P ＜0.05）。慢性肝炎组与肝硬化组HBV载量差异无统计学意义（ P ＞0.05）；HBeAg阴性患者T1762/A1764，T1766/A1768，A1896变异位点发生率较HBeAg阳性患者显著增高（ P ＜0.05）。结论 T1762/A1764，A1896突变率的增加会促使肝脏疾病进展至肝硬化；HBeAg阴患者T1762/A1764，T1766/A1768，A1896变异位点的频率增加会促进肝脏疾病的进展。

英文摘要：

Objective To investigate the association of hepatitis B virus （ HBV） precore （ preC） /C mutations with the pro-gression of liver disease .Methods The HBV genes of 50 chronic hepatitis B , including 30 HBV e-antigen （ HBeAg）-negative and 20 HBeAg-positive patients, were detected with real-time quantification polymerase chain reaction （RT-PCR） and the direct sequencing method.Results The mutations T1762/A176, T1766/A1768, A1896 , and the levels of HBV viral loads significantly correlated with the disease progression .The HBeAg-negative patients had a higher frequency of mutations at T 1762/A1764 , T1766/A1768 , and A 1896 relative to HBeAg-positive patients .Conclusions Patients with advanced liver diseases and with HBeAg-negativity possibly had multi-mutations at T1762/A1764, T1766/A1768, and A1896 in HBV genomes.