干扰素α-1b序贯拉米夫定联合治疗对慢性乙型肝炎患儿T淋巴细胞亚群、补体水平及肝功能的影响  

Effect of interferon α-1b sequential Lamivudine combined therapy on T lymphocyte subsets, complement levels and liver function in children with chronic hepatitis B

作　　者：李博[1] 郑欢伟[2] 赵召霞[3] 李健霞 许剑萍[5] 金鹏[6] LI Bo;ZHENG Huanwei;ZHAO Zhaoxia;LI Jianxia;XU Jianping;JIN Peng(Department of Pediatrics,Shijiazhuang Fifth Hospital,Hebei Province,Shijiazhuang 050024,China;Department of Infectious Disease,Shijiazhuang Fifth Hospital,Hebei Province,Shijiazhuang 050024,China;Department of Clinical Laboratory,Shijiazhuang Fifth Hospital,Hebei Province,Shijiazhuang 050024,China;Department of Obstetrics and Gynecology,Pingshan County Hospital of Traditional Chinese Medicine,Hebei Province,Shijiazhuang 050400,China;Department of Obstetrics and Gynecology,the Fifth Hospital of Shijiazhuang City,Hebei Province,Shijiazhuang 050024,China;Department of Scientific Education,Shijiazhuang Fifth Hospital,Hebei Province,Shijiazhuang 050024,China)

机构地区：[1]石家庄市第五医院儿科,河北石家庄050024 [2]石家庄市第五医院感染科,河北石家庄050024 [3]石家庄市第五医院检验科,河北石家庄050024 [4]河北省平山县中医院妇产科,河北石家庄050400 [5]石家庄市第五医院妇产科,河北石家庄050024 [6]石家庄市第五医院科教科,河北石家庄050024

出　　处：《中国医药导报》2019年第14期148-151,共4页China Medical Herald

基　　金：河北省医学科学研究重点课题计划(20181073)

摘　　要：目的探讨干扰素α-1b序贯拉米夫定联合治疗对慢性乙型肝炎患儿T淋巴细胞亚群、补体表达水平的影响,并对其肝功能进行评价。方法选取2015年11月~2017年12月石家庄市第五医院(以下简称“我院”)收治的136例慢性乙型肝炎患儿作为研究对象,根据随机数字表法将其分为研究组和对照组,每组68例。对照组患者仅给予肌内注射干扰素α-1b。研究组采用拉米夫定联合干扰素α-1b治疗。观察两组治疗前后T淋巴细胞亚群(CD4^+、CD8^+、CD4^+/CD8^+)及CD8^+T细胞PD-1、Tim-3表达量、补体(C3、C4)水平;观察两组治疗前后谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBil)水平的变化。结果研究组治疗后CD4^+、CD4^+/CD8^+水平高于对照组,CD8^+水平低于对照组,差异均有统计学意义(P<0.05)。研究组治疗后CD8+T细胞PD-1、CD8^+Tim-3水平低于对照组,C3、C4水平均高于对照组,差异均有统计学意义(P<0.05)。两组治疗后ALT、AST、TBil均较治疗前降低,且研究组低于对照组,差异有统计学意义(P<0.05)。结论拉米夫定联合干扰素α-1b治疗小儿慢性乙型肝炎可以明显改善患儿的T淋巴细胞亚群,且HBVDNA、HBsAg、HBeAg水平得到明显改善,具有显著的抗肝纤维化的作用。Objective To investigate the effects of interferonα-1b sequential Lamivudine on the expression of T lymphocyte subsets and complement in children with chronic hepatitis B,and to evaluate liver function.Methods A total of 136 children with chronic hepatitis B admitted to the Shijiazhuang Fifth Hospital(“our hospital”for short)from November 2015 to December 2017 were selected as subjects.They were divided into study groups according to the random number table method,and 68 cases in each group.The control group received only intramuscular injection of interferonα-1b.The study group was treated with Lamivudine combined interferonα-1b.The T lymphocyte subsets(CD4^+,CD8^+,CD4^+/CD8^+),CD8^+T cell PD-1,Tim-3 expression,complement(C3,C4)levels were observed before and after treatment in two groups.The levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST)and total bilirubin(TBil)were observed before and after treatment in both groups.Results After treatment,the levels of CD4^+,CD4^+/CD8^+in the study group were higher than those in the control group,and the levels of CD8^+in the study group were lower than those in the control group(P<0.05).After treatment,the levels of CD8^+T cell PD-1,CD8^+Tim-3 in the study group were lower than those in the control group,while the levels of C3 and C4 in the study group were higher than those in the control group(P<0.05).After treatment,ALT,AST and TBil in the two groups were lower than those before treatment,and the differences between the study group and the control group were statistically significant(P<0.05).Conclusion Lamivudine combined with interferonα-1b in the treatment of children with chronic hepatitis B can significantly improve the T lymphocyte subsets of children,HBV DNA,HBsAg,HBeAg levels are significantly improved,with significant anti-fibrosis effect.

关 键 词：乙型肝炎 患儿 干扰素 拉米夫定 T淋巴细胞亚群 补体 肝功能 

分 类 号：R512.62[医药卫生—内科学]