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目的：运用基因芯片技术分析黑龙江地区乙型肝炎病毒（HBV）基因型分布特征及基因耐药变异情况。方法：随机选择2012 年11 月至2015 年11 月本医院乙型肝炎患者血清样本400例，应用PCR- 反向点杂交的基因芯片技术对样本血清中HBV基因型及常见4 类抗病毒药物耐药相关的多个位点进行检测，并进行数据分析。结果：400 例样本中基因型分布以C 型为主占83.25 %（333 例），B 型7.25 %（29 例）、D 型0.25 %（1例）及混合基因型2.75 %（11 例）；耐药突变位点检出188 例，总耐药率为45.19 %，其中突变位点236T（4.61 %）提示阿德福韦酯单项耐药，耐药率为5.82 %（10 例），与拉米夫定耐药相关的为126 例，突变位点以rt204I和(rt180M+rt240V)为主，显著高于其他抗病毒类药物，耐药风险较高。结论：黑龙江地区乙型肝炎基因分型以C 为主，B 型和其它混合型较少，且更容易对拉米夫定产生耐药。

英文摘要:

Objective:To investigate the distribution characteristics of hepatitis B virus (HBV) genotypes and the variation situation of drug resistance gene in Heilongjiang area by the gene chip technology.Methods:Serum samples were randomly collected from 400 patients of hepatitis B in our hospital from November 2012 to November 2015. The HBV genotypes and drug resistance associated multiple sites in common 4 types of antiviral drugwere detected by the gene chip technology of PCRcombinedwith reverse dot blot.Results:Among 400 samples in Heilongjiang area, 83.25 %genotypes were genotype C (333 cases), type B 7.25 % (29 cases), type D 0.25 % (1 case) and mixed type 2.75%(11 cases); 188 sites were found to be resistance mutants, the total resistance frequency was 45.19 %, rt236T mutations in 10 samples prompted drug resistance-mutations for Adefovir drug, and the resistance frequency was 5.82 %, and 126 samples drugs resistance-mutations was Lamivudine drug in major of rt204I and (rt180M+rt204V). 126 cases were related with Lamivudine resistance, which was significantly higher than other antiviral drugs, the risk of drug resistance was greater.Conclusion:The main HBV genotype is the genotype C in Heilongjiang area, genotype B and mixed genotype are unusual, which is more likely to happen resistance to Lamivudine.

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