慢性乙肝病毒感染患者肝纤维化、肝功能及Th1/Th2细胞因子水平变化及恩替卡韦干预研究  

Changes of Hepatic Fibrosis, Liver Function and Th1/Th2 Cytokine Levels in Patients with Chronic Hepatitis B Virus Infection and the Intervention Effect of Entecavir

作　　者：葛婷婷 刘希双[2] 刘福国[2] 孙学国[2] 沈剑华 GE Ting-ting;LIUXi-shuang;LIUFu-guo;SUNXue-guo;SHENJian-hua(Qingdao University Medical College,Qingdao,Shandong,266071,China;Department of Gastroenterology,Affiliated Hospital of Qingdao University,Qingdao,Shandong,266000,China)

机构地区：[1]青岛大学医学院,山东青岛266071 [2]青岛大学附属医院消化内科,山东青岛266000

出　　处：《现代生物医学进展》2021年第10期1972-1977,共6页Progress in Modern Biomedicine

基　　金：山东省医药卫生科技发展计划项目(2015WSA13054)。

摘　　要：目的:研究慢性乙肝病毒(HBV)感染患者肝纤维化、肝功能及Th1/Th2细胞因子水平的变化情况,并分析恩替卡韦干预对慢性HBV感染患者相关指标的影响.方法:选择2016年4月至2018年1月我院收治的120例慢性HBV感染者为研究对象,其中慢性乙肝轻度50例、中度24例、重度21例、肝硬化者25例,并选择同期于我院进行体检的50例健康者为健康对照组,分析不同病情慢性HBV感染患者血清中的肝纤维化指标[透明质酸(HA)、Ⅳ型胶原(ⅣC),层粘连蛋白(LN)、Ⅲ型前胶原肽(PCⅢ)]、肝功能指标[丙氨酸转氨酶(ALT)、天冬氨酸转移酶(AST)]及Th1/Th2细胞因子[干扰素-γ(IFN-γ)、白介素-2(IL-2)、白介素-4(IL-4)、白介素-6(IL-6)]的变化,慢性HBV感染患者按照随机数字表法分为观察组和对照组,对照组给予还原型谷胱甘肽和复方甘草酸苷等常规护肝治疗,观察组在对照组基础上另口服恩替卡韦分散片治疗,对比两组治疗前后各指标水平.结果:慢性HBV感染患者的肝纤维化指标、肝功能指标及Th1/Th2细胞因子IL4、IL-6等指标水平均显著高于健康对照组,且随着病情的加重呈逐渐上升趋势;而IFN-γ和IL-2水平均低于健康对照组,随着病情的加重而逐渐降低(P<0.05).治疗后两组血清肝纤维化指标(HA、ⅣC、LN、PCⅢ)、肝功能指标(ALT、AST)以及IL-4、IL-6水平均显著低于治疗前,且观察组低于对照组(P<0.05).治疗后两组血清IFN-γ、IL-2水平均高于治疗前,且观察组高于对照组(P<0.05).结论:慢性HBV感染患者存在肝纤维化水平上升、肝功能受损及Th1/Th2细胞失衡,恩替卡韦联合常规护肝治疗可有效纠正患者的Th1/Th2细胞失衡,减轻患者的肝纤维化,改善其肝功能.Objective:To study the changes of hepatic fibrosis,liver function and Th1/Th2 cytokine levels in patients with chronic hepatitis B virus(HBV)infection,and to analyze the effect of entecavir intervention on related indexes of patients with chronic HBV.Methods:120 case of patients with chronic HBV infective who were admitted to our hospital from April 2016 to January 2018 were selected as the objects,among them 50 mild cases,24 moderate cases,21 severe cases and 25 cirrhosis cases.And then 50 cases of healthy persons who were admitted to hospital for physical examination at the same time were selected as the healthy control group.The liver fibrosis indexes[hyaluronidase(HA),collagen type IV(ⅣC),laminin(LN)and procollagen peptide type III(PC III)],liver function indexes[alanine aminotransferase(ALT)and aspartate transferase(AST)]and Th1/Th2 cytokines[interferon-γ(IFN-γ),interleukin-2(IL-2),IL-4 and IL-6]in the serum were analyzed among patients with different conditions of chronic HBV infection.Then the patients were divided into observation group and control group according to random number table method.The control group was treated with routine liver protection therapy such as reduced glutathione and compound glycyrrhizin,and the observation group was treated with entecavir dispersible tablets on the basis of the control group.The changes of all indexes between two groups before and after treatment were compared.Results:The indexes of hepatic fibrosis indexes,liver function indexes,Th1/Th2 cytokines IL-4 and IL-6 in patients with HBV infective were significantly higher than those in the healthy control group,and gradually increased with the severity,while the levels of IFN-γand IL-2 were lower than those of the healthy control group,and gradually decreased with the aggravation of the disease(P<0.05).After treatment,the levels of serum hepatic fibrosis indexes(HA,IVC,LN and PC III)),the liver function indexes(ALT and AST),IL-4 and IL-6 in the two groups were significantly lower than those before treatment,and

关 键 词：慢性乙肝病毒感染 肝纤维化 肝功能 TH1/TH2细胞因子 恩替卡韦 

分 类 号：R512.62[医药卫生—内科学]