替比夫定治疗e抗原阳性慢性乙型肝炎患者Treg/Th17比率变化及与抗原血清学转换的关系研究  

Relationship between Treg/Th17 ratio and HBe Ag seroconversion in HBe Ag positive chronic hepatitis B patients receiving telbivudine antiviral treatment

作　　者：李成伟[1] 那妍[1] 陈佳佳[1] 李岩[1] 夏华[1] 赵钰[1] 贾玲[1] 娄宪芝[1] 

机构地区：[1]沈阳医学院附属中心医院感染科,沈阳110024

出　　处：《中国实用内科杂志》2015年第6期525-527,共3页Chinese Journal of Practical Internal Medicine

基　　金：2012沈阳市卫生局科研课题

摘　　要：目的研究替比夫定治疗慢性乙型肝炎(CHB)患者过程中Treg/Th17比率变化及与e抗原(HBe Ag)血清学转换的关系。方法收集2011年10月至2013年10月在沈阳医学院附属中心医院感染科应用替比夫定治疗的34例HBe Ag阳性CHB患者,在治疗前及治疗第4周、12周、24周、36周、48周,分别检测乙型肝炎标志物、肝功能、HBV DNA,Treg细胞频数、Th17细胞频数。同时选择20名健康志愿者为对照组。结果 Treg/Th17比率在第4周开始下降,至第12周达到最低值。在治疗第12周时Treg/Th17比率与HBe Ag血清学转换有显著相关性,且治疗过程中发生HBe Ag血清学转换的10例CHB患者的Treg/Th17比率与未发生HBe Ag血清学转换的24例患者的Treg/Th17比率比较差异有统计学意义。结论替比夫定治疗CHB患者过程中,Treg/Th17比率呈现动态变化,12周时Treg/Th17比率与HBe Ag血清学转换密切相关,可能成为HBe Ag血清学转换的预测指标。Objective To explore the correlations of Treg/Thl7 ratio with HBeAg seroconversion in HBeAg positive chronic hepatitis B patients receiving telbivudine antiviral treatment. Methods A total of 34 chronic hepatitis B patients with positive HBeAg were enrolled. The peripheral blood Treg cell frequenc）~ Thl7 cell frequenc）5 HBV-DNA, ALT levels and hepatitis B virus markers were detected before and 4, 12, 24, 36, 48 weeks after telbivudin treatment. The peripheral blood Treg cell frequency and Th17 cell frequency of 20 health volunteers were detected as well. Results Treg/Th17 ratio decreased from the 4th week and reached the lowest point at the 12th week. At the 12th week, Treg/Thl7 ratio showed significant correlation with HBeAg seroconversion, and Treg/ Th17 ratio was significantly different between the patients with and without HBeAg seroconversion. Conclusion Treg/Tnl7 ratio changes in HBeAg positive chronic hepatitis B patients receiving telbivudine antiviral treatment. At the 12th week, Treg/Thl7 ratio shows significant correlation with HBeAg seroconversion, which may serve as a predictive marker of HBeAg seroconversion..

关 键 词：慢性乙型肝炎 替比夫定 TREG细胞 Th17细胞 

分 类 号：R512.62[医药卫生—内科学]