膦甲酸钠抗乙肝病毒疗效与血清IL-2、TNF-α变化的关系  

Study on the Relation between Changes of IL-2, TNF-αin Serum in Patients with Chronic Hepatitis B and Action of Treatment with Foscarnet

作　　者：丁红芳[1] 田德英[1] 黄元成[1] 雷洪波[1] 张振刚[1] 

机构地区：[1]华中科技大学同济医学院同济医院,武汉430030

出　　处：《中西医结合肝病杂志》2001年第5期262-264,共3页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

摘　　要：探讨慢性乙型肝炎(CHB)患者采用膦甲酸钠(PFA)抗病毒治疗前、中、后血清白细胞介素-2(IL-2),肿瘤坏死因子-α(TNF-α)水平的变化与HBeAg、HBV DNA定量变化的关系及PFA对机体的免疫调节作用。方法:选择慢性乙型肝炎患者30例,给予膦甲酸钠注射液2.4g/次静滴,Bid,疗程28d,收集治疗前、中、后血清标本,采用FQ-PCR法(荧光定量PCR)检测HBV DNA含量、双抗体放射免疫法测定血清IL-2水平及顺序饱和法测定TNF-α水平。结果:14/30(46.7％)例患者治疗结束后HBV DNA、HBeAg阴转,ALT复常,为应答组;16/30(53.3％)例患者上述指标无变化,为无应答组。应答组(14例)治疗前、中、后HBV DNA定量分别为4.52±1.14、3.40±1.20和0QTY/μl(对数值);而无应答组(16例)分别为4.43±1.29、4.12±1.02和3.83±1.06QTY/μl。治疗中期有8例HBV DNA阴转,阴转率为26.7％(8/30),其中4例HBeAg阴转,阴转率为13.3％(4/30),治疗结束后14例HBV DNA阴转的病例中10例HBeAg阴转,占33.3％(10/30)。无论是应答组还是无应答组,治疗前血清IL-2及TNF-α水平均较正常组为高(P<0.05)。在治疗过程中,应答组IL-2及TNF-α有所上升,无应答组IL-2及TNF-α有所下降,但经统计分析P>0.05,均无明显临床意义。结论:膦甲酸钠具有明显抑制乙肝病毒复制的作用,但短期内?To investigate the relationships between the changes of Interleukin-2 (IL-2), Tumor necrosis factor (TNF-α) in serum and antiviral action of Foscarnet in patients with chronic hepatitis B(CHB) and the immunoreg-ulation of PFA. Methods: A series of serum samples from 30 patients of chronic hepatitis B were analyzed about alterations in serum quantification of HBV DNA, the levels of IL-2 and TNF-α before, during and after Foscarnet treatment. The serum HBV DNA concentrations were tested by the Fluorescence quantitative PCR (FQ-PCR). The levels of IL-2 and TNF-α were tested by RLA. Results: The experimental date showed that there were 14 patients whose HBV DNA, HBeAg became negative after treatment among the 30 samples (46.7%). It was called response group. The others (16) had not changed (53. 3%). That was the nonresponse group. The average levels of the HBV DNA quantification respectively were 4.52±1. 14、3. 40±1. 20、0 QTY/μl (logarithm) in the response group, and 4. 43±1.29、4. 12±1.02、 3. 83±1. 06QTY/μl (logarithm) in the nonresponse group before during and after treatment. The levels of IL-2, TNF-α both were higher than the normal in the two groups before treatment (P<0. 05). In the process of PFA treatment, the levels of IL-2 and TNF-α were elevated in the response group (P>0. 05), and decreased in the nonresponse group. But there was not difference after statistics analysis. Conclusion: The results suggested that Foscarnet can pronouncedly inhibit the replication of HBV, but it did not play a role in the body's immunoregulation in short-term.

关 键 词：慢性乙型肝炎 白细胞介素-2 肿瘤坏死因子-Α 膦甲酸钠 

分 类 号：R512.6[医药卫生—内科学]