恩替卡韦治疗HBeAg阳性慢性乙型肝炎抗病毒效应评估  

Assessment of antiviral effect of entecavir on treatment of HBeAg-positive chronic hepatitis B

作　　者：王健 吴东洋 郑建兴 张金凤 王利民 WANG Jian;WU Dong-yang;ZHENG Jian-xing;ZHANG Jin-feng;WANG Li-min(Tangshan Central Hospital,Tangshan,Hebei 063000,China)

机构地区：[1]唐山中心医院介入手术室,河北唐山063000 [2]唐山中心医院肝胆外科,河北唐山063000

出　　处：《中华医院感染学杂志》2023年第5期652-656,共5页Chinese Journal of Nosocomiology

基　　金：河北省卫生厅医学科学研究重点基金资助项目(202013ZK4314)。

摘　　要：目的探讨恩替卡韦治疗乙型肝炎e抗原(HBeAg)阳性慢性乙型肝炎(CHB)的抗病毒效应。方法回顾性选取2020年1月-2021年12月在唐山中心医院确诊的90例CHB患者,所有患者均予以恩替卡韦口服,持续治疗4周后,根据抗病毒效应分为完全应答组62例和未完全应答组28例。比较两组基线资料,检测治疗前、治疗4周后HBeAg、乙型肝炎病毒脱氧核糖核酸(HBV-DNA)水平、炎症因子[白细胞介素(IL)-17、IL-10、IL-21与IL-6]与Toll样受体4(TLR4)/IL-6信号通路表达。结果治疗后,完全应答组HBeAg、HBV-DNA水平降低程度均高于未完全应答组(P<0.05)。治疗后完全应答组血清IL-17、IL-10、IL-21和IL-6下降程度均高于未完全应答组(P<0.05),外周血TLR4 mRNA、TLR4蛋白、NF-κB蛋白和p-NF-κB蛋白表达下降程度均高于未完全应答组(P<0.05)。结论HBeAg阳性CHB患者经恩替卡韦治疗后HBV-DNA水平显著降低,其抗病毒效应机制可能与下调了TLR4/IL-6信号通路有关。OBJECTIVE To explore the relationship between expression of Toll-like receptor 4/interleukin-6(TLR4/IL-6)in peripheral blood of patients with hepatitis B e antigen(HBeAg)-positive chronic hepatitis B(CHB)and antiviral effect.METHODS Totally 90 patients who were diagnosed with CHB in Tangshan Central Hospital from Jan 2020 to Dec 2021 were retrospectively recruited as the research subjects,all of the patients were given oral administration of entecavir and were divided into the complete response group with 62 cases and the partial response group with 28 cases according to the antiviral effect after continued treatment for 4 weeks.The baseline data were compared between the two groups,and the levels of HBeAg,hepatitis B virus deoxyribonucleic acid(HBV-DNA)and inflammatory factors[interleukin(IL)-17(IL-17),IL-10,IL-21,IL-6]as well as expression levels of TLR4/IL-6 signaling pathways were detected before the treatment and after the treatment for 4 weeks.RESULTS The reduced degree of HBeAg and HBV-DNA of the complete response group was higher than that of the partial response group after the treatment(P<0.05).The declined degree of serum IL-17,IL-10,IL-21 and IL-6 of the complete response group was higher than that of the partial response group after the treatment(P<0.05);the decline degree of expression of TLR4 mRNA,TLR4 protein,NF-κB protein and p-NF-κB protein in peripheral blood was higher in the complete response group than in the partial response group(P<0.05).CONCLUSION The HBV-DNA level of the HBeAg-positive CHB patients is significantly reduced after treatment with entecavir,and the mechanisms of antiviral effect may be associated with the downregulation of TLR4/IL-6 signaling pathways.

关 键 词：乙型肝炎E抗原 慢性乙型肝炎 乙型肝炎病毒 乙肝病毒DNA Toll样受体4/白细胞介素-6 抗病毒效应 恩替卡韦 

分 类 号：R512.62[医药卫生—内科学]