慢性乙型肝炎患者免疫细胞功能分析与恩替卡韦治疗效果研究

T cells function and influence of entecavir therapy on chronic HBV infection patients

  • 摘要: 目的 分析慢性乙型肝炎病毒(HBV)感染患者体内免疫细胞水平特征,及应用恩替卡韦治疗后免疫细胞水平的变化,指导临床治疗实践。方法 选择2013年9月-2014年10月医院就诊56例慢性乙型肝炎病毒感染者作为观察组,同期选取15名健康志愿者作为对照组,所有慢性乙型肝炎病毒感染者均给予口服恩替卡韦治疗,于治疗前和服药后3、6、9、12个月用ELISA法检测所有患者血清细胞因子IFN-γ和IL-10水平,数据采用SPSS 13.0软件进行统计分析。结果 观察组HBeAg阳性患者与治疗前相比,完全应答患者IFN-γ水平逐渐升高,IL-10水平逐渐降低;部分应答患者治疗9个月后IFN-γ/IL-10达最高水平为(0.66±0.17),仍低于对照组,但与治疗前比较差异有统计学意义(P<0.05);HBeAg阴性患者治疗后IL-10水平不断降低,IFN-γ/IL-10不断升高,治疗9个月时IFN-γ/IL-10da达到最高水平0.54±0.19,低于正常对照组,但与治疗前比较差异有统计学意义(P<0.05)。结论 慢性乙型肝炎感染患者血清IFN-γ降低,IL-10升高,且Th1/Th2比例失衡,这可能与HBV感染的慢性化相关;恩替卡韦治疗后慢性乙型肝炎患者的细胞免疫反应有一定程度恢复。

     

    Abstract: OBJECTIVE To analyze immune cell level feature in chronic HBV infection patients and the changes of immune cells after treating with entecavir and to provide basis for clinical treatment. METHODS A total of 56 cases of chronic HBV patients treated in our hospital were selected as observation group, and 15 healthy volunteers were selected as control group. All patients with chronic HBV infection were given entecavir by oral administration, and IFN-γ and IL-10 levels before the treatment and after treating for 3, 6, 9 and 12 months were all detected by ELISA serum cytokines. The results were statistically analyzed by software SPSS13.0. RESULTS Compared with before treatment, the complete response of IFN-γ levels rose and IL-10 levels of patients in HBeAg positive group gradually reduced; the highest level of IFN-γ/IL-10 of patients with partial response after nine months treatment was 0.66±0.17 which was still lower than that of control group, but it had significant difference compared with before treatment (P<0.05); The level of IL-10 of the HBeAg-negative patients was continuously reduced after the treatment, the IFN-γ/IL-10 was continuously elevated; the IFN-γ/IL-10 reached the highest level (0.54±0.19) after the treamtnet for 9 months, while there was significant difference between the observation group and the control group before the treatment (P<0.05). CONCLUSION The levels of IFN-γ rise and IL-10 reduce in chronic HBV patients, which may have some relation to chronicity of HBV infection. Entecavir for cellular immune response in patients with chronic HBV has a certain recovery.

     

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