摘要
目的探讨拉米夫定联合干扰素(IFN-α)治疗慢性乙型肝炎(乙肝)抗病毒疗效与Th细胞因子的变化关系。方法以慢性乙肝患者39例作为治疗组,采用拉米夫定联合IFN-α治疗,拉米夫定100 mg.d-1,po;IFN-α5MU,隔日肌内注射。联合治疗1 a后检测患者外周血HBV-DNA及Th细胞因子IL-2、IFN-γ、IL-4、IL-10;以20例健康献血员作为正常对照组。并根据HBV-DNA复制指标及HBeAg/HBeAb转换情况将治疗组分为有效组与无效组。结果治疗组治疗后血清IL-2、IFN-γ均值明显升高(P<0.05)、HBV-DNA含量均值明显下降(P<0.05);治疗有效组与无效组比较,血清IL-2、IFN-γ均值明显升高(P<0.05),IL-4、HBV-DNA含量均值明显下降(P<0.05)。结论拉米夫定联合IFN-α治疗慢性乙肝可显著抑制HBV-DNA复制;联合治疗后有效组免疫状态可由以Th2型为主向以Th1型为主转换。
Objective To probe into the relationship between the antiviral effect and changes in levels of Th cytokines in the treatment of chronic hepatitis B using lamivudine combined with alpha interferon. Methods 39 patients with chronic hepatitis B and 20 healthy blood donors served as the subjects of the study. The patients were given each 100 mg of lamivudine PO, q. d. and 5 MU of IFN-α IM, q. o. d.. The course of the combined treatment lasted 1 year. The healthy blood donors, acting as normal controls, were subjected to no drug treatment. Serum levels of IL-2, IFN-γ, IL-4 and IL-10 as well as HBV-DNA both of the patients and blood donors were determined with ELISA and PCR before and 1 year after the treatment of the patients, respectively. The patients were then subdivided into the effective group and the ineffective group according to HBV-DNA replication index and the situation of the conversion of HBeAg into HbeAb. Results After the combined treatment of the patients, serum levels of IL-2 and IFN-γ were significantly higher （P 〈 0.05 ） while HBV-DNA level was significantly lower （ P 〈 0.05 ） than those before the treatment. Furthermore, serum levels of IL-2 and IFN-γ/were significantly higher （ P 〈 0.05 ）, while those of IL-4 and HBV-DNA were significantly lower （ P 〈 0.05 ） in patients of the effective group as compared with those of the ineffective group. Conclusion Lamivudine combined with alpha interferon was shown to have a striking inhibitory effect on the replication of HBV-DNA in the treatment of patients with chronic hepatitis B. In patients of the effective group after the treatment, the immune state of the body was converted from a chiefly Th2 type into a chiefly Th1 type.
出处
《医药导报》
CAS
2005年第12期1118-1120,共3页
Herald of Medicine
关键词
拉米夫定
干扰素
肝炎
乙型
慢性
Lamivudine
Interferon
Hepatitis B , chronic
