恩替卡韦治疗HBeAg阳性乙肝肝硬化患者对血清免疫球蛋白和补体水平的影响  

Effect of Entecavir on the Immunoglobulin and Complement Levels of Cases with HBeAg-positive Hepatitis B Cirrhosis

作　　者：周健[1] 黄丽雯[1] 刘黎[1] Zhou Jian;Huang Liwen;Liu Li(Department of Integrated Traditional Chinese Medicine&Western Medicine,Tianyou Hospital Affiliated to Wuhan University of Science&Technology,Wuhan,Hubei Province,430064,P.R.China)

机构地区：[1]武汉科技大学附属天佑医院中西医结合科,湖北武汉430064

出　　处：《西南军医》2020年第2期110-113,共4页Journal of Military Surgeon in Southwest China

摘　　要：目的观察恩替卡韦治疗HBeAg阳性乙肝肝硬化患者对血清免疫球蛋白和补体水平的影响。方法 70例乙型肝炎E抗原(hepatitis Be antigen,HBeAg)阳性乙肝肝硬化患者根据肝硬化程度、乙肝病毒脱氧核糖核酸(HBV DNA)、抗病毒疗效分组。比较各组血清免疫球蛋白IgG、IgA、IgM和补体C3、C4表达水平。结果不同应答组患者治疗后血清免疫球蛋白表达水平明显降低(P<0. 05),而血清补体表达水平明显升高(P<0. 05),且治疗前后完全应答组血清免疫球蛋白表达水平明显低于部分应答组(P<0. 05),血清补体表达水平明显高于部分应答组(P<0. 05)治疗后肝硬化失代偿期组和肝硬化代偿期组患者血清免疫球蛋白表达水平明显降低(P<0. 05),而血清补体表达水平明显升高(P<0. 05),且治疗后肝硬化代偿期组血清免疫球蛋白表达水平明显低于肝硬化失代偿期组(P<0. 05),血清补体表达水平明显高于肝硬化失代偿期组(P<0. 05);不同载量组治疗前血清免疫球蛋白(IgG、IgA、IgM)表达水平存在明显差异性(P<0. 05),治疗前后高、中及低病毒载量组血清免疫球蛋白、补体表达水平依次明显降低或升高(P<0. 05)。结论恩替卡韦可明显降低血清免疫球蛋白表达水平和提高血清补体水平,在抑制乙肝肝硬化患者体液免疫方面具有一定的作用。Objective To observe the effect of entecavir on the immunoglobulin and complement levels of cases with HBeAg-positive Hepatitis B cirrhosis. Methods 70 cases with HBeAg-positive Hepatitis B cirrhosis were enrolled;based on different cirrhosis features,cases were divided into compensated cirrhosis group and decompensated cirrhosis group;based on the level of HBV DNA,cases were divided into low level group( 103 copies/m L ~ 105 copies/m L),medium level group( 105 copies/m L ~ 107 copies/m L) and high level group( ≥107 copies/m L);based on the curative effect after treatment,cases were divided into complete responding group,partial responding group and non-responding group;the levels of IgG,IgA,IgM,C3 and C4 of cases were observed and compared among different groups. Results Decrease in IgG,IgA and IgM levels and increase in C3 and C4 levels were observed in all cases( P<0. 05);cases in complete responding group were of lower levels of IgG,IgA and IgM and higher levels of C3 and C4 than those in partial responding group( P < 0. 05);cases in compensated cirrhosis group were of lower levels of IgG,IgA and IgM and higher levels of C3 and C4 than those in decompensated cirrhosis group( P<0. 05);cases in compensated cirrhosis group were of lower levels of IgG,IgA and IgM and higher levels of C3 and C4 than those in decompensated cirrhosis group( P<0. 05);the sequence of IgG,IgA and IgM levels from high to low and C3 and C4 levels from low to high was: high level group,medium level group and low level group( P<0. 05). Conclusions Entecavir can obviously decrease the levels of IgG,IgA and IgM and increase the levels of C3 and C4 and it is of certain effect in inhibiting humoral immunity in cases with HBeAg-positive Hepatitis B cirrhosis.

关 键 词：恩替卡韦 乙型肝炎 肝硬化 免疫球蛋白 补体 

分 类 号：R512.62[医药卫生—内科学]