聚乙二醇干扰素α-2b对慢性乙型肝炎患者的免疫调节及抗病毒效果分析  

Effects of Pegylated Interferon α-2b on Immunomodulation and Antiviral Activity of Patients with Chronic Hepatitis B

作　　者：李杰[1] 刘红云[1] 王小莉[2] 

机构地区：[1]利川市人民医院药剂科,湖北利川445400 [2]十堰市太和医院生命科学研究所,湖北十堰442000

出　　处：《解放军医药杂志》2017年第8期86-89,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：湖北省教育厅中青年人才项目(Q20162110)

摘　　要：目的探讨不同剂量聚乙二醇干扰素α-2b与恩替卡韦联合治疗慢性乙型肝炎的抗病毒效果,及其对免疫调节功能的影响。方法选择2014年1—12月利川市人民医院收治的慢性乙型肝炎患者180例,按治疗方法分为高剂量组、低剂量组和对照组,每组60例。对照组单纯口服恩替卡韦进行治疗,高剂量组和低剂量组分别在对照组基础上给予聚乙二醇干扰素α-2b 1.5μg/kg和1.0μg/kg肌内注射,治疗48周后比较3组近期疗效、乙型肝炎病毒-DNA(HBV-DNA)水平、T淋巴细胞亚群变化、自然杀伤细胞(NK)活性与白介素-2(IL-2)变化及不良反应情况。结果治疗后,高剂量组与低剂量组的完全应答率与持续应答率均高于对照组(P<0.05),且高剂量组高于低剂量组(P<0.05);高剂量组和低剂量组HBV-DNA和CD8+水平低于对照组(P<0.05),且高剂量组低于低剂量组(P<0.05);高剂量组和低剂量组NK活性、IL-2、CD3+、CD4+和CD4+/CD8+水平高于对照组(P<0.05),且高剂量组高于低剂量组(P<0.05);高剂量组和低剂量组不良反应总发生率均低于对照组(P<0.05)。结论高剂量聚乙二醇干扰素α-2b与恩替卡韦联合治疗慢性乙型肝炎,能够有效抑制病毒复制,增强机体免疫力,提高近期疗效,且不良反应少。Objective To investigate effects of different doses of Pegylated Interferon α -2b combined with Entecavir on antiviral activity and immunomodulation in treatment of patients with chronic hepatitis B. Methods A total of 180 patients with chronic hepatitis B from January to December 2014 were divided into high-dose, low-dose and control groups according to therapeutic method （n = 60 for each group）. Control group was treated with peroral Entecavir only, while high-dose and low-dose groups were added with 1.5 μg/kg and 1.0 μg/kg Pegylated Interferon α -2b by intramuscular injection on the basis of treatment for control group. After treatment for 48 weeks, short-term effect, hepatitis b virus-DNA （HBV-DNA） level, changes of T-lymphocyte subsets, natural killer （NK） cell activity and interleukin-2 （IL- 2） levers and incidence rate of adverse reaction were compared among the 3 groups. Results After treatment, complete response and sustained response rates in high-dose and low-dose groups were significantly higher than those in control group （P 〈 0. 05 ） , and the rates in high-dose group were significantly higher than those in low-dose group （P 〈 0.05 ） ; HBV-DNA and CD8＋ levels in high-dose and low-dose groups were significantly lower than those in control group （P 〈 0.05 ） , and the levels in high-dose group were significantly lower than those in low-dose group （ P 〈 0. 05 ） ; values of NK activity and IL-2, CD3 ＋ , CD4 ＋ and CD4 ＋ /CD8 ＋ levels in high-dose and low-dose groups were significantly higher than those in control group （P 〈 0.05） , and the values in high-dose group were significantly higher than those in low- dose group （P 〈 0.05 ） ; incidence rates of adverse reaction in high-dose and low-dose groups were significantly lower than that in control group （P 〈 0. 05）. Conclusion High-dose Pegylated Interferon α -2b combined with Entecavir in treatment of patients with chronic hepatitis B can effectively restrain virus replication, enhan

关 键 词：乙型肝炎 慢性 聚乙二醇干扰素Α-2B 恩替卡韦 免疫调节 治疗效果 

分 类 号：R512.62[医药卫生—内科学]