富马酸替诺福韦二吡呋酯对慢性重型乙型肝炎患者的免疫及炎性反应影响  

The effects of tenofovir dipivoxil fumarate on immune and inflammatory responses in patients with chronic severe hepatitis B

作　　者：吴娜 苏汝开[1] 张建秋 阮建文[1] Wu Na;Su Rukai;Zhang Jianqiu;Ruan Jianwen(Department of Infectious Diseases,Haikou People's Hospital,Hainan Province,Haikou 570208,China)

机构地区：[1]海口市人民医院感染性疾病科,海口570208

出　　处：《疑难病杂志》2023年第12期1302-1306,1317,共6页Chinese Journal of Difficult and Complicated Cases

基　　金：海南省自然科学基金面上项目(820MS161)。

摘　　要：目的观察富马酸替诺福韦二吡呋酯对慢性重型乙型肝炎患者免疫、炎性反应水平的影响。方法选取2021年3月—2022年3月海口市人民医院感染性疾病科诊治慢性重型乙型肝炎患者114例,采用随机数字表法分为观察组57例和对照组57例。对照组给予常规支持治疗及恩替卡韦口服治疗,观察组给予常规支持治疗及富马酸替诺福韦二吡呋酯口服治疗。比较2组患者治疗6个月内肝功能指标(ALT、AST、TBil、Alb)、细胞免疫相关指标(CD4+T淋巴细胞比例、CD8+T淋巴细胞比例、CD4+/CD8+比值)、血清炎性相关指标(TGF-β1、IL-6、TRIM5α、SOCS-1、PD-1)水平,以及药物不良反应发生率。结果治疗6个月后,观察组血清ALT、AST及TBil均低于对照组,Alb高于对照组(t/P=10.632/<0.001,6.216/<0.001,6.090/<0.001,3.943/<0.001);CD4+T淋巴细胞比例及CD4+/CD8+比值均高于对照组,CD8+T淋巴细胞比例低于对照组(t/P=6.229/<0.001、5.567/<0.001、3.737/<0.001);血清TGF-β1、IL-6及PD-1水平均低于对照组,TRIM5α及SOCS-1水平均显著高于对照组(t/P=7.249/<0.001、5.395/<0.001、8.658/<0.001、13.451/<0.001、7.195/<0.001)。治疗过程中,观察组患者总药物不良反应发生率低于对照组患者(χ^(2)/P=4.222/0.040)。结论富马酸替诺福韦二吡呋酯能显著改善慢性重型乙型肝炎患者的肝功能及细胞免疫功能,同时能显著抑制患者体内炎性反应,降低抗病毒药物导致的不良反应发生率。Objective To investigate the effect of tenofovir dipivoxil fumarate on immune and inflammatory response levels in patients with chronic severe hepatitis B.Methods One hundred and fourty patients with chronic severe hepatitis B were selected from the Infectious Diseases Department of Haikou People's Hospital from March 2021 to March 2022.They were randomly divided into an observation group of 57 patients and a control group of 57 patients.The control group received routine support therapy and entecavir oral treatment,while the observation group received routine support therapy and tenofovir dipivoxil fumarate oral treatment.Compare the liver function indicators(ALT,AST,TBil,Alb),cellular immune related indicators(CD4+T lymphocyte ratio,CD8+T lymphocyte ratio,CD4+/CD8+ratio),and serum inflammatory related indicators(TGF)between two groups of patients within 6 months of treatment-β1.IL-6,TRIM5α、The levels of SOCS-1 and PD-1,as well as the incidence of adverse drug reactions.Results After 6 months of treatment,the serum ALT,AST,and TBil levels in the observation group were lower than those in the control group,while Alb levels were higher than those in the control group(t/P=10.632/<0.001,6.216/<0.001,6.090/<0.001,3.943/<0.001).The proportion of CD4+T lymphocytes and CD4+/CD8+ratio were higher than those in the control group,while the proportion of CD8+T lymphocytes was lower than that in the control group(t/P=6.229/<0.001,5.567/<0.001,3.737/<0.001).The levels of serum TGF-β,IL-6 and PD-1 in the control group were lower than those in the control group;TRIM5αThe levels of SOCS-1 were higher than those of the control group(t/P=7.249/<0.001,5.395/<0.001,8.658/<0.001,13.451/<0.001,7.195/<0.001).During the treatment process,the total incidence of adverse drug reactions in the observation group was lower than that in the control group(χ^(2)/P=4.222/0.040).Conclusion Tenofovir dipivoxil fumarate can significantly improve liver function and cellular immune function in patients with chronic severe hepatitis B,while sign

关 键 词：慢性重型乙型肝炎 富马酸替诺福韦二吡呋酯 肝功能 细胞免疫功能 炎性反应 

分 类 号：R512.62[医药卫生—内科学]