恩替卡韦抗病毒治疗后老年慢性乙肝患者外周血T淋巴细胞亚群的变化  

Changes of peripheral blood T-lymphocyte subsets in elderly patients with chronic hepatitis B after receiving entecavir antiviral therapy

作　　者：张小玉[1] 张红梅[1] 杨永峰[1] 王雷[1] 俞海英[1] 潘剑[1] 郭银燕[1] 丁巧云[1] 

机构地区：[1]东南大学医学院附属南京市第二医院肝病科,南京市210003

出　　处：《中华全科医学》2015年第1期33-35,137,共4页Chinese Journal of General Practice

摘　　要：目的探讨恩替卡韦抗病毒治疗后老年慢性乙型肝炎患者外周血T淋巴细胞亚群、肝功能、HBV-DNA载量变化及其临床意义。方法采集经恩替卡韦治疗12和24周的慢性乙肝患者的外周血单个核细胞,通过流式细胞技术检测CD3+、CD4+、CD8+细胞的绝对计数值并分析其与乙型肝炎病毒HBV-DNA载量水平和血清总胆红素(Tbi L)、血清丙氨酸氨基转移酶(ALT)的相关性,并与正常对照者进行比较。结果老年慢乙肝患者经恩替卡韦治疗后,其外周血T淋巴细胞CD3+、CD4+、CD8+绝对计数值明显高于治疗前(P<0.05),治疗24周后分别为1091.6、992.3、651.2,较治疗前分别增长了46.2%、49.4%、53.9%;各组老年患者TBi L水平、HBV-DNA载量及ALT较治疗前明显好转,血清ALT、TBi L水平及HBV-DNA载量水平与CD3+、CD4+、CD8+失衡存在一致性。结论恩替卡韦抗病毒治疗慢性乙型肝炎老年患者后,肝功能明显改善,HBV-DNA复制明显减少,外周血淋巴细胞亚群绝对细胞数CD3+、CD4+和CD8+进行性升高,T细胞亚群的比例呈逐渐改善趋势。Objective To discuss the changes and clinical significance of T lymphocyte subsets,liver function and HBV- DNA levels in elderly patients with chronic hepatitis B after entecavir antiviral therapy. Methods The peripheral blood mononuclear cells were collected from patients with chronic hepatitis B receiving 12 and 24 weeks of antiviral therapy to determine the absolute count value of CD3＋ ,CD4＋ and CD8 ＋ cells by using flow cytometry;its correlation with the hepa- titis B virus HBV-DNA load levels, serum total bilirubin （TbiL） and serum alanine aminotransferase （ALT） were ana- lyzed,and compared with the normal control. Results The absolute count of CD3＋ , CD4 ＋ and CD8 ＋in peripheral blood increased obviously after the entecavir antiviral therapy （P 〈 0.05 ）, the values 24 weeks later were 1091.6,992.3 and 651.2 ,respectively ,account for 46.2% ,49.4% and 53.9%. The levels of TBiL, HBV-DNA load and ALT levels were improved significantly after the therapy, and were consistent with the imbalance of CD3＋ , CD4 ＋ and CD8 ＋cells. Conclu- sion The enteeavir antiviral therapy in elderly patients with chronic hepatitis B can effectively improve the liver function of patients, decrease the replication of HBV-DNA, increase the absolute cell number of CD3＋ , CD4 ＋ and CD8＋ in periph- eral blood, and improve gradually the proportion of T cell subsets.

关 键 词：恩替卡韦 老年乙肝患者 CD3+ CD4+ CD8+ 

分 类 号：R512.62[医药卫生—内科学] R446.11[医药卫生—临床医学]