目的了解我国献血者HBV基因MHR区、PreS区、逆转录酶区及PreC/BCP区序列变异特征;分析HBV序列变异与HBV基因型、亚型、献血者人口地理特征及献血者HBV血清学特征的关系。方法从昆明、洛阳、柳州、绵阳、乌鲁木齐5家血液中心(或中心血站)2008~2010年HBsAg确证阳性献血者标本中,随机抽取245份:用巢式PCR法扩增PreS/S区、S区、PreC/BCP区并双向测序,用ClustalⅩ将测序结果与标准株序列比对分析是否存在重要位点突变;将测序结果翻译成氨基酸后与标准株的氨基酸序列比对分析是否存在S区和逆转录酶编码区突变。用SPSS 11.0统计软件比较序列变异的地理分布、人口特征分布、基因型和亚型分布以及其与献血者HBV病毒学特征和血清学特征的关系。结果献血者HBV基因MHR区突变率为17.1%(39/228),B基因型中MHR区的突变率高于C基因型(23.1%vs 4.0%)。PreS区突变率为14.0%(28/200),包括PreS区缺失以及T31C和T53C突变;PreS区发生缺失者占2.5%(5/200),且所有D基因型标本中均未发现D基因型特有的PreS区33个核苷酸的缺失;C型PreS区突变率高于B型(26.0%vs和5.2%),C2亚型高于B2亚型(42.5%vs 3.8%)。PreC/BCP区突变率为29.8%(68/228),C型中A1762T/G1764A联合突变率高于B型(34.0%vs 4.48%),B型中G1896A突变发生率高于C型(26.9%vs 8.0%),PreC/BCP区变异标本的HBeAg阳性率明显低于无该区突变标本(11.8%vs 26.7%,P<0.05)。逆转录酶区突变率为7.0%(14/200),其突变位点突变位点主要与阿德福韦酯和拉米夫定耐药有关,未发现最典型的YMDD拉米夫定突变。结论我国献血者HBV基因MHR区突变尽管低于其他国家的比例,但在HBV基因各重要区域中的序列变异率仍为最高;献血者HBV基因与肝细胞癌相关的突变主要位于PreC/BCP区,在PreS区的较少;C基因型中PreS区突变率和A1762T/G1764A联合突变率高于B型,B基因型中G1896A突变率高于C型;献血者感染的HBV存在逆转录酶区耐药突变。 Objective To understand the sequence variation of HBV gene MHR, PreS, reverse transcriptase and PreC / BCP in blood donors in China. To analyze the relationship between HBV sequence variation and HBV genotypes, subtypes, blood donors’ geographic features and HBV serology Relationship. Methods 245 HBsAg positive donors were collected from 5 blood centers (or center blood stations) in Kunming, Luoyang, Liuzhou, Mianyang and Urumqi from 2008 to 2010, and PreS / S region was amplified by nested PCR. S region, PreC / BCP region and two-way sequencing, the sequencing results were compared with the standard strain sequence by Clustal X for the presence or absence of important site mutations; the sequencing results were translated into amino acids and amino acid sequence comparison with the standard strains for the presence of S region And reverse transcriptase coding region mutations. The geographical distribution of population variation, distribution of population characteristics, genotypes and subtypes, and their relationship with HBV virological and serological characteristics of blood donors were compared using SPSS 11.0 statistical software. Results The rate of MHR mutation in blood donors was 17.1% (39/228). The mutation rate of MHR in B genotype was higher than that in genotype C (23.1% vs 4.0%). The PreS mutation rate was 14.0% (28/200), including PreS deletion and T31C and T53C mutations. PreS deletion accounted for 2.5% (5/200), and no D genotype was found in all D genotypes The deletion of 33 nucleotides was found in PreS region. The mutation rate of PreS region was higher than that of B (26.0% vs 5.2%). The C2 subtype was higher than that of B2 (42.5% vs 3.8%). The mutation rate of PreC / BCP was 29.8% (68/228), the combined mutation rate of A1762T / G1764A in type C was higher than that of type B (34.0% vs 4.48%), and the rate of G1896A mutation in type B was higher than that of type C (26.9% vs 8.0%). The positive rate of HBeAg in PreC / BCP region was significantly lower than that in non-region (11.8% vs 26.7%, P <0.05). The mutation rate of reverse transcriptase was 7.0% (14/200). The mutation site of mutation was mainly related to adefovir dipivoxil and lamivudine resistance, and the most typical mutation of lamivudine YMDD was not found. Conclusion Although the mutation of MHR region of HBV gene in blood donors in our country is lower than that of other countries, the sequence variation rate in all important regions of HBV gene is still the highest. The mutations of HBV gene and hepatocellular carcinoma in blood donors are mainly located in PreC / BCP region , But less in PreS region. The mutation rates of PreS region and A1762T / G1764A in C genotype were higher than those in B genotype. The mutation rate of G1896A in B genotype was higher than that of C genotype. The reverse transcriptase region Drug-resistant mutation.