替诺福韦治疗慢性乙型肝炎患者临床疗效分析  

Clinical efficacy of tenofovir in the treatment of chronic hepatitis B

作　　者：沈金勇 何然 邓红梅[1] 温思炯 郭翔云[1] Shen Jinyong;He Ran;Deng Hongmei;Wen Sijiong;Guo Xiangyun(Department of infection,Bazhong Central Hospital,Bazhong 636000,China)

机构地区：[1]四川省巴中市中心医院感染科,636000

出　　处：《国际病毒学杂志》2021年第2期154-157,共4页International Journal of Virology

摘　　要：目的探讨替诺福韦治疗慢性乙型肝炎(chronic hepatitis B,CHB)血清细胞因子水平检测及其与疾病进展的关系。方法选取2017年5月至2019年5月期间我院收治的226例CHB患者作回顾性分析,其中113例患者作为对照组,采用拉夫米定口服治疗方式;113例患者作为观察组,采用替诺福韦酯口服治疗方式,比较两组之间治疗前后血清免疫因子、HBV DNA(hepatitis B virus deoxyribo nucleic acid,HBV DNA)、谷丙转氨酶(alanine aminotransferase,ALT)和乙型肝炎e抗原(hepatitis Be antigen,HBeAg)水平变化以及HBV DNA阴转率、ALT复常率、HBeAg阴转率和转换率以及不良用药反应等相关指标。结果两组给药前IL-2、IL-10、sICAM-1指标、HBV DNA、ALT、HBeAg水平以及不良反应发生率比较,差异均无统计学意义(P>0.05)。与对照组相比,观察组CHB患者给药后的IL-2、sICAM-1指标更低,IL-10指标更高,经比较,差异有统计学意义(P<0.05)。与对照组相比,观察组CHB患者给药后的HBV DNA、ALT、HBeAg水平更低,差异有统计学意义(P<0.05)。与对照组相比,观察组CHB患者的HBV DNA转阴率、ALT复常率、HBeAg转阴率及转换率较高,差异有统计学意义(P<0.05)。结论TDF能有效改善CHB患者的肝功能及免疫功能,有较高的临床应用价值,值得临床推广。Objective To investigate the relationship between serum cytokine levels and disease progression in patients with chronic hepatitis B(CHB)treated with tenofovir.Methods A total of 226 patients with CHB admitted to our hospital from May 2017 to May 2019 were selected for retrospective analysis.One hundred and thirteen patients treated with lamivudine were selected as control group and 113 patients receiving oral therapy of tenofovir dipivoxil fumarate(TDF)were selected as observation group.The related indicators in both groups were compared,including the levels of serum immune factors,hepatitis B virus deoxyribonucleic acid(HBV DNA),alanine aminotransferase(ALT)and hepatitis B e-antigen(HBeAg)before and after treatment,as well as negative conversion rates of HBV DNA,normalization rate of ALT,the negative conversion rate and sero-conversion rate of HBeAg,the adverse drug reactions and other indicators.Results The differences among the levels of IL-2,IL-10,sICAM-1,HBV DNA,ALT,HBeAg and the incidence of adverse reactions before treatment in both groups were not statistically significant.After treatment,the levels of IL-2 and sICAM-1 in the observation group were lower than those in the control group while IL-10 was higher in the observation group.The differences were statistically significant(P<0.05).Compared with the control group,the levels of HBV DNA,ALT and HBeAg after treatment in the observation group were lower,and the difference was statistically significant(P<0.05).The HBV DNA negative conversion rate,ALT normalization rate,HBeAg negative conversion rate and sero-conversion rate among CHB patients in the observation group were higher,and the differences were statistically significant(P<0.05).Conclusions TDF can effectively improve the liver function and immune function of patients with CHB,showing high application value and worth of promotion in clinical practice.

关 键 词：替诺福韦 慢性乙型肝炎 血清细胞因子 可溶性细胞间黏附分子-1 

分 类 号：R512.62[医药卫生—内科学]