拉米夫定对PBMC及血清内HBV-DNA的阴转和细胞因子的诱导作用  

The negative of Lamivudine on HBV-DNA in PBMC and its inducement effect against cytokine

作　　者：王健[1] 项桂菊[2] 王自林[3] 

机构地区：[1]安徽理工大学医学院病原学与免疫学教研室,淮南232001 [2]安徽省淮南第二矿工医院感染科 [3]安徽理工大学附属医院感染科

出　　处：《中华微生物学和免疫学杂志》2005年第12期1023-1026,共4页Chinese Journal of Microbiology and Immunology

摘　　要：目的探讨拉米夫定对慢性乙肝患者外周血单个核细胞(PBMC)及血清内HBV-DNA的阴转效果和对细胞因子的影响。方法将81例慢性乙肝患者分为A(47例)、B(34例)两组,分别采用拉米夫定和常规治疗,于治疗前后分别检测患者PBMC、血清中HBV-DNA和细胞因子水平。结果拉米夫定治疗36周后,慢性乙肝患者PBMC内和血清中HBV-DNA阴转率分别为55.32%(26/47)和61.70%(29/47),常规治疗组PBMC内和血清中HBV-DNA阴转率分别为26.47%(9/34)和32.35%(11/34),两者相比差异有统计学意义(P<0.01)。拉米夫定治疗24、36周后,慢性乙肝患者血清HBeAg的阴转率分别为46.81%(22/47)和68.09%(32/47),与常规治疗组相比,差异有统计学意义(P<0.05和P<0.01)。采用拉米夫定和常规治疗后,丙氨酸转氨酶(ALT)、门冬氨酸转氨酸(AST)、ALT/AST水平分别为(30.1±9.6)U/ml、(32.3±10.7)U/ml、0.9±0.1和(48.4±10.7)U/ml、(44.7±11.0)U/ml、1.1±0.2,差异有统计学意义(P<0.01)。慢性乙肝患者IL-6、IL-8、TNF-α表达水平较高,拉米夫定可显著下调IL-6、IL-8、TNF-α至(250.5±33.3)pg/ml、(153.4±22.2)pg/ml、(232.6±21.2)pg/ml,与常规治疗组相比差异有统计学意义(P<0.01)。结论拉米夫定对PBMC及血清内HBV-DNA均具有较好的治疗效果,其阴转率明显高于常规治疗法。拉米夫定比常规药物更具有减轻局部炎性细胞因子浸润、分泌和促进肝细胞功能恢复的作用。Objective To study the therapeutic effect of Lamivudine on the negative effect of HBV-DNA in peripheral blood mononuclear cells（PBMC） and serum and the level of cytokines in serum of the patients with chronic hepatitis B. Methods The total of 81 patients were divided into two groups（A = 47, B = 34）, and treat- ed by Lamivudine, routine medicine, respectively. The levels of HBV-DNA in PBMC and serum and cytokines were all detected before and after treatment. Results After the treatment of Lamivudine for 36 weeks, the total negative conversion rates of HBV-DNA in PBMC and serum of the patients treated with Lamivudine were 55.32% （ 26/47 ） and 61.70% （29/47）, respectively. The total negative conversion rates of HBV-DNA in PBMC and serum of the patients treated by routine medicine were 26.47% （9/34） and 32.35% （11/34）, respectively. There was significant difference between in Lamivudine group and in routine medicine group（ P 〈 0.01 ）. The negative rates of HBeAg in serum of the patients were 46.81%（22/47） and 68.09%（32/47） at end of 12 weeks and 24 weeks, and were higher than those of routine medicine group（ P 〈 0.05 and P 〈 0.01 ）. The levels of ALT, AST, ALT/ AST in serum of the patients after being treated by Lamivudine and routine medicine were down-regulated to （30.1 ±9.6） U/ml, （32.3±10.7） U/ml, 0.9±0.1 and （48.4±10.7） U/ml, （44.7±11.0） U/ml, 1.1±0.2. After the analysis of variance, the high significant difference was obvious between two groups（ P 〈 0.01）. It was in factor that the high level of IL-6, IL-8 and TNF-α in chronic hepatitis B could be down-regulated to （250.5 ± 33.3） μg/ml, （153.4±22.2）μg/ml, （232.6±21.2） μg/ml by Lamivudine, which was more obvious than that of routine medicine （ P 〈 0.01）. Conclusion Lamivudine has high therapeutic effect on the treatment of HBV-DNA in PBMC and serum and has better therapeutic effect than that of routine therapy. Lamivudine may also have higher down-regulate inflamm

关 键 词：拉米夫定 慢性乙型肝炎 外周血单个核细胞(PBMC) HBV-DNA 细胞因子 

分 类 号：R512.62[医药卫生—内科学] R817.44[医药卫生—临床医学]