聚乙二醇干扰素α-2a联合替诺福韦酯对高病毒载量慢性乙肝初治患者血清Mig、RANTES及肝纤维化指标表达的影响  

Effect of peginterferon α-2a and Tenofovir Disoproxil on the expression of serum Mig, RANTES and indicators of hepatic fibrosis in newly diagnosed chronic hepatitis B patients with high viral load

作　　者：李骁 LI Xiao(Department of Infectious Disease,West China-Guang′an Hospital,Sichuan University,Sichuan Province,Chengdu638000,China)

机构地区：[1]四川大学华西广安医院感染科

出　　处：《中国医药导报》2020年第1期165-168,共4页China Medical Herald

摘　　要：目的探讨聚乙二醇干扰素α-2a联合替诺福韦酯对高病毒载量慢性乙肝初治患者血清γ干扰素诱导的单核因子(Mig)、调节活化正常T细胞表达和分泌的趋化因子(RANTES)及肝纤维化指标表达的影响。方法选取2016年6月~2017年12月于四川大学华西广安医院进行治疗的168例HBeAg阳性慢性乙肝患者,按照随机数字表法将其分为试验组和对照组,各84例。对照组患者接受替诺福韦酯单药治疗,试验组在此基础上加用聚乙二醇干扰素α-2a,两组均治疗6个月。比较两组患者的治疗效果和血清Mig、RANTES及肝纤维化指标。结果试验组患者的HBV DNA转阴率、HbeAg转阴率和HBeAg血清转换率均显著高于对照组(P <0.05)。治疗后两组患者Mig和RANTES水平均较治疗前显著降低(P <0.05),且试验组Mig和RANTES水平低于对照组(P <0.05)。治疗后两组患者血清肝纤维化指标(透明质酸、层粘连蛋白、Ⅳ型胶原蛋白和Ⅲ型前胶原蛋白)水平均较治疗前显著下降(P <0.05),且试验组治疗后血清肝纤维化指标水平低于对照组(P <0.05)。结论聚乙二醇干扰素α-2a联合替诺福韦酯能显著降低乙肝患者血清Mig和RANTES水平,有效改善乙肝患者肝纤维化指标,值得临床推广。Objective To investigate the effect of peginterferon α-2 a combined with Tenofovir Disoproxil on serum monokine induced by interferon-γ(Mig), regulated upon activation normal T-cell expressed and secreted factors(RANTES) and indicators of liver fibrosis in newly diagnosed chronic hepatitis B patients with high viral load.Methods A total of 168 patients with HBeAg-positive chronic hepatitis B treated in West China-Guang′an Hospital,Sichuan University from June 2016 to December 2017 were selected and divided into the experimental group and the control group by random number table method, with 84 cases in each group. The patients in the control group received monotherapy with Tenofovir Disoproxil, on basis of which, the patients in the experimental group were added with peginterferon α-2 a, and both groups were treated for 6 months. The therapeutic effects and serum Mig, RANTES and indicators of liver fibrosis were compared between the two groups. Results The HBV DNA negative rate, HbeAg negative rate and HBeAg seroconversion rate in the experimental group were significantly higher than those in the control group(P < 0.05). After treatment, the Mig and RANTES levels in the two groups were significantly lower than those before treatment(P < 0.05), and the Mig and RANTES levels in the experimental group were significantly lower than those in the control group(P < 0.05). After treatment, the indicators of liver fibrosis(hyaluronic acid, laminin, collagen-Ⅳ and procollagen-Ⅲ) in the two groups were significantly lower than those before treatment(P < 0.05), and the levels of indicators of liver fibrosis in the experimental group were significantly lower than those in the control group(P <0.05). Conclusion Pegylated interferon α-2 a combined with Tenofovir Disoproxil can significantly reduce the levels of serum Mig and RANTES in patients with hepatitis B, and effectively improve the indicators of liver fibrosis in patients with hepatitis B, which is worthy of clinical promotion.

关 键 词：乙型肝炎 肝纤维化 γ干扰素诱导的单核因子 调节活化正常T细胞表达和分泌的趋化因子 

分 类 号：R575[医药卫生—消化系统]