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目的:观察拉米夫定治疗的慢性乙型肝炎患者在治疗后及病毒变异后血清IFN-γ、IL-2和IL-4水平的变化。方法:选择用拉米夫定治疗而发生病毒变异及未变异的慢性乙型肝炎患者各29例,另选择20例健康人作为对照组,治疗6个月后、病毒变异后的ELISA法检测外周血血清IFN-γ、IL-2、IL-4水平,并对HBV DNA、ALT水平进行检测。结果:在治疗后6个月时,未变异组血清IFN-γ、IL-2、IL-4及HBV DNA、ALT水平与变异组相比差异均无统计学意义(P均>0.05);但在病毒变异后,变异组IFN-γ、IL-2水平均低于未变异组(P均<0.01),而IL-4、HBV DNA和ALT水平则高于未变异组(P均<0.01)。结论:应用拉米夫定抗病毒治疗致病毒变异后,机体出现免疫功能改变。
Objective: To observe the changes of serum levels of IFN-γ, IL-2 and IL-4 in patients with chronic hepatitis B after lamivudine treatment and after virus mutation. Methods: Twenty-nine patients with chronic hepatitis B who were treated with lamivudine and no mutation were selected. Twenty healthy subjects were selected as control group. After six months of treatment, Serum levels of IFN-γ, IL-2 and IL-4 were measured and HBV DNA and ALT levels were detected. Results: At 6 months after treatment, the serum levels of IFN-γ, IL-2, IL-4, HBV DNA and ALT in the non-mutation group were not significantly different from those in the mutation group (all P> 0.05) The levels of IFN-γ and IL-2 in the mutation group were lower than those in the non-mutation group (P <0.01), while the levels of IL-4, HBV DNA and ALT in the mutation group were higher than those in the non-mutation group (P <0.01) . Conclusion: The application of lamivudine antiviral treatment of viral mutations, the body appeared immune function changes.