论文部分内容阅读
目的探讨聚乙二醇干扰素α-2a联合阿德福韦酯对乙型肝炎E抗原(HBe Ag)阳性慢性乙型肝炎(CHB)患者细胞免疫功能影响。方法选取鹤壁市传染病医院2010年1月—2013年1月收治的200例HBe Ag阳性CHB患者,随机分为观察组和对照组,每组100例。观察组采用聚乙二醇干扰素α-2a联合短程阿德福韦酯治疗,对照组采用拉米夫定加阿德福韦酯治疗,观察两组治疗6个月前后临床疗效、免疫功能、肝功能、安全性与不良反应发生率。结果观察组谷丙转氨酶(ALT)正常化率、HBe Ag转阴率或转换率和乙肝病毒脱氧核糖核酸(HBV-DNA)转阴率均明显高于对照组,差异有统计学意义(P<0.05);观察组患者治疗结束及随访6个月时血清干扰素-γ(IFN-γ)、白细胞介素-2(IL-2)水平均明显高于治疗前,且观察组均明显高于对照组,差异均有统计学意义(P<0.05);观察组患者治疗后阳性辅助性T淋巴细胞(CD4)、抑制性/细胞毒性T淋巴细胞(CD4/CD8)升高,与治疗前比较差异有统计学意义(P<0.05),且组间比较差异亦有统计学意义(P<0.05);观察组患者治疗后ALT、谷草转氨酶(AST)、直接胆红素水平均明显低于治疗前,组间差异亦有统计学意义(P<0.05或P<0.01)。两组患者用药安全性与不良反应发生率比较,差异无统计学意义(P>0.05)。结论聚乙二醇干扰素α-2a联合短程阿德福韦酯治疗HBe Ag阳性CHB临床效果显著,能够促进T淋巴细胞的增殖、分化、成熟和分泌功能,提高体内IFN-γ、IL-2水平,激活免疫。
Objective To investigate the effect of peginterferon alfa-2a combined with adefovir dipivoxil on cellular immunity in patients with chronic hepatitis B (HBeAg) -positive hepatitis B (HBeAg) -positive hepatitis B (CHB). Methods 200 cases of HBeAg-positive CHB patients who were treated in Hebi City Infectious Disease Hospital from January 2010 to January 2013 were randomly divided into observation group and control group with 100 cases in each group. The observation group was treated with peginterferon alfa-2a combined with short-course adefovir dipivoxil, the control group was treated with lamivudine plus adefovir dipivoxil, and the clinical efficacy, immune function, Liver function, safety and incidence of adverse reactions. Results The ALT normalization rate, HBeAg negative conversion rate and HBV-DNA negative rate in the observation group were significantly higher than those in the control group (P < 0.05). The levels of serum IFN-γ and IL-2 in the observation group at the end of treatment and at the 6th month of follow-up were significantly higher than those before treatment, and the observation group were significantly higher than those in the observation group (P <0.05). The positive T-lymphocyte (CD4) and inhibitory / cytotoxic T lymphocyte (CD4 / CD8) in the observation group were significantly higher than those before treatment The difference was statistically significant (P <0.05), and there was significant difference between the two groups (P <0.05). The ALT, AST and direct bilirubin levels in the observation group were significantly lower than those in the treatment group Before and after the group differences were also statistically significant (P <0.05 or P <0.01). There was no significant difference between the two groups in medication safety and incidence of adverse reactions (P> 0.05). Conclusions Peginterferon alfa-2a and short-course adefovir dipivoxil are effective in treating HBeAg-positive CHB, which can promote the proliferation, differentiation, maturation and secretion of T lymphocytes and increase the levels of IFN-γ, IL-2 Level, activate immunity.