INFα-2b联合恩替卡韦对慢性乙型肝炎患者病毒载量、外周血中Th1/Th2型细胞因子与肝功能的改善效果  

Effect on viral load,Th1/Th2 type cytokines and liver function of chronic hepatitis B patients treated with enticavir combined with IFN α-2b

作　　者：梁超[1] 段卫星[1] 李卫强[2] LIANG Chao;DUAN Wei-Xing;LI Wei-Qiang(Jiyuan People＇s Hospital,Jiyuan 459000,Henan,China)

机构地区：[1]济源市人民医院,河南济源459000 [2]宁夏医科大学

出　　处：《中国老年学杂志》2018年第21期5210-5213,共4页Chinese Journal of Gerontology

基　　金：国家自然科学基金项目支持(No.81560769)

摘　　要：目的研究干扰素(INF)α-2b联合恩替卡韦对慢性乙型肝炎(CHB)患者乙型肝炎病毒(HBV)病毒载量、外周血中Th1/Th2型细胞因子与肝功能的改善效果。方法选取CHB患者96例,随机分为对照组和观察组各48例。对照组给予恩替卡韦口服治疗,观察组在对照组的基础上联合INFα-2b肌肉注射治疗,疗程均为48 w。比较两组治疗后HBV载量、Th1/Th2型细胞因子、肝功能指标、治疗效果及不良反应发生率的差异。结果治疗后,观察组HBV载量明显低于对照组及同组治疗前(P<0. 05)。两组INF-γ、肿瘤坏死因子(TNF)-α指标均明显低于治疗前,白细胞介素(IL)-4、IL-6、IL-10均明显高于治疗前(均P<0. 05)。观察组治疗后INF-γ水平明显低于对照组(P<0. 01),IL-6水平明显高于对照组(P<0. 05)。观察组总胆红素(TBiL)复常率、HBV-DNA转阴率、治疗总有效率均明显高于对照组,差异有统计学意义(均P<0. 05)。观察组不良反应发生率与对照组比较差异无统计学意义(P>0. 05)。结论 INFα-2b联合恩替卡韦治疗CHB的临床疗效显著,可有效降低患者外周血Th1型细胞因子水平,升高Th2型细胞因子水平,改善肝功能,且未增加患者不良反应。Objective To evaluate the effect of interferon alpha-2 b（INF α-2 b） combined with entecavir on viral load,Th1/Th2 type cytokines and liver function in patients with chronic hepatitis B.Methods 96 patients with chronic hepatitis B from January2016 to January 2017 were randomly divided into control and observation groups with 48 cases in each group. Patients in the control group received entecavir monotherapy and patients in the observation group received INFα-2 b combined with entecavir. The differences in HBV viral load,Th1/Th2 cytokines,liver function,treatment efficacy and incidence of adverse events between the two groups were compared.Results After 48 weeks of treatment,the HBV load（1.91 ± 1.36） in the observation group was significantly lower than that in the control group（2.73±1.68）（t= 2.63,P= 0.01）. The levels of IL-4,IL-6 and IL-10 in both groups were significantly lower than those before treatment and the differences were statistically significant（ P〈0.05）. The level of INF-γ in peripheral blood of the observation group（15.43 ± 2.17） was significantly lower than that of the control group（18.60 ± 1.99）（ t = 7.46,P = 0.00）. IL-6 level（ 17.91 ± 4.74） was significantly higher than that of the control group（14.77 ± 6.28）,the difference was statistically significant（ t = 2.76,P = 0.01）. The rate of abnormal TBiL in observation group（83.33%） was significantly higher than that in control group（ 56.25%）,the difference was statistically significant（ t = 8.35,P = 0.00）. The negative rate of HBV-DNA in the observation group was 72.92%,which was significantly higher than that in the control group（45.83%）（ t = 7.30,P = 0.01）. The total effective rate（ 89.58%） in observation group was significantly higher than that in control group（ 64.58%）（ χ^2= 8.49,P = 0.01）. The incidence of adverse reactions in the observation group（27.08%） was lower than that in the control group（29.17%）,but the difference was not statistically signifi

关 键 词：干扰素Α-2B 恩替卡韦 慢性乙型肝炎 病毒载量 

分 类 号：R512.62[医药卫生—内科学]