泰来肽治疗HBV携带者临床疗效观察以及对细胞免疫功能影响  

A Clinical Observation and Follow-up for Patients with HBV Carrier after the Treatment of Anti-hepatitis B Placenta Transfer Factor.

作　　者：施军平[1] 过建春[1] 刘雁[1] 陈群伟[1] 石伟珍[1] 荀运浩[1] 王宇芳[1] 

机构地区：[1]浙江省杭州市第六人民医院杭州市肝病研究所,310014

出　　处：《医学研究杂志》2007年第1期32-34,共3页Journal of Medical Research

摘　　要：目的观察泰来肽治疗HBV携带者的临床疗效及其可能作用机制。方法选择100例HBV-DNA和HBeAg阳性的HBV携带者,分为治疗组(45例)和对照组(54例)。结果治疗24周时,治疗组HBeAg阴转率、血清转换率和HBV-DNA阴转率分别为11.11%、6.67%和17.78%明显高于对照组(P<0.01);治疗组和对照组ALT异常率分别为4.44%、1.92%,两组间无显著性差异(P>0.05)。随访24周后,治疗组HBeAg阴转率、血清转换率和HBV-DNA阴转率分别为26.67%、17.78%和37.78%明显高于对照组(P<0.01);治疗组和对照组ALT异常率分别为4.44%、5.77%,两组比较无显著性差异(P>0.05)。组织学炎症分期为G1、G2的HBeAg阴转率(36.36%,50%)、血清转换率(22.27%,40%)、HBV-DNA阴转率(44.54%,60%)均明显高于G0-1(P<0.01)。治疗组外周血T细胞(CD3+)、CD4+T细胞(CD3+CD4+)和NK细胞(CD16+CD56+)计数较治疗前明显增高(P<0.05),而CD8+T细胞(CD3+CD8+)计数较治疗前明显降低(P<0.05),外周血B细胞(CD19+)计数无明显变化(P>0.05)。结论泰来肽能使HBV携带者HBeAg和HBV-DNA阴转,以及HBeAg发生血清转换,且与肝组织学炎症分期有关,提高细胞免疫功能是其主要作用机制。Objective To investigate the effects of anti - hepatitis B placenta transfer factor on HBV carrier and reveal the underlying mechanisms. Methods A total of 100 patients divided into two groups with HBeAg - positive and HBV - DNA positive HBV carrier received either anti - hepatitis B placenta transfer factor（ treatment group, n = 45） or placebo（ control group, n = 54）. All the Patients were treated for 24 weeks and followed for additional 24 weeks. Results After 24 weeks of treatment, HBeAg negatively conversed in 11.11% patients of treatment group versus 0% in control group（P 〈 0.01 ）, HBeAg seroconversion achieved in 6.67% patients of treatment group versus 0% in control group （ P 〈 0. 01 ）. The rate of patients with HBV DNA load below 1,000 copies per milliliter was 17.78% in treatment group versus 3.85 % in control group （ P 〈 0. 01 ）. No significant differences were found between the rate of ALT abnormality of the two groups （4.44% vs. 1.92% ,P 〉0.05） After 24 weeks of followup, the treatment groups displayed significant higher HBeAg negative rate, proportion of HBeAg seroconversion, and HBV DNA negative rate （26.67% , 17.78% , and 37.78% , respectively,P 〈 0.01 ） compared with the control group. There were no significant differences found between the rate of ALT abnormality of the two groups （4. 44% vs. 5.77% , P 〉 0.05 ）. Compared with patients with inflammation stage G0-1 ,patients with inflammation stage G1 and G2 displayed significantly higher HBeAg negative rate, proportion of HBeAg seroconversion, and HBV DNA negative rate（P 〈 0.01 ）. In the treatment group, the counts of peripheral CD3^＋ T cells, CD4^＋ T （ CD3^＋ CD4^＋） cells, and NK cells（ CD16^＋ CD56 ^＋） were significantly higher while the count of CD8^＋ T cell（ CD3^＋ CD8 ^＋） was significantly lower after treatment. No significant difference were found between the counts of peripheral B cells （ CD19^＋） before and after treatment. Conclusions The HBeAg and HBV - DNA

关 键 词：HBV携带者 随访研究 泰来肽 

分 类 号：R512.62[医药卫生—内科学]