摘要
目的探讨慢性乙肝(chronic hepatitis B,CHB)患者的机体免疫状态与病毒载量及抗病毒疗效的关系。方法将237例CHB患者按照乙肝病毒(hepatitis B virus,HBV)载量,分为病毒阴性组、低病毒载量组和高病毒载量组,比较各组的免疫球蛋白、补体及T细胞亚群等免疫指标的差异。对其中符合抗HBV治疗指征的患者给予抗HBV治疗,观察治疗半年后的病毒学应答情况和治疗1年后的e抗原血清学应答情况,分析初始免疫状态与抗病毒疗效的关系。结果随着HBV-DNA载量的升高,CHB患者的CD3+、CD4+及CD8+T细胞计数随之升高,而CD4+/CD8+比值随之下降(P<0.05)。完全病毒学应答组和部分/无病毒学应答组的初始免疫指标比较,差异无统计学意义(P>0.05)。获得e抗原血清学转换者与未获得e抗原血清学转换者相比,在开始抗病毒治疗时的ALT和AST水平更高(P<0.05),但初始免疫指标差异无统计学意义(P>0.05)。结论 CHB患者的免疫状态与HBV-DNA载量相关,CD3+、CD4+及CD8+T细胞计数随着HBV-DNA载量的升高而升高,而CD4+/CD8+比值则随之下降。CHB患者在抗病毒治疗时的初始免疫状态与病毒学应答及e抗原血清学转换无明显相关性。
Objective To investigate the relationship between immune states and virus load and efficacy of antiviral therapy on hepatitis B virus （HBV）. Methods A total of 237 patients with chronic hepatitis B （CHB） were divided into negative viral load group, low viral load group and high viral load group. The immune indexes such as immunoglobulin （Ig）, complement （C） and T-lymphocyte subsets of above-mentioned groups were tested and analyzed. The patients in accordance with anti-HBV treatment indications were given antiviral therapy, whose virological response and e antigen sero-conversion were observed. Results As viral load elevated,the counts of CD3^＋ T cell,CD4^＋ T cell and CD8＋T cell of CHB patients gradually increased, while the ratio of CD4^＋/CD8^＋ gradually declined（P〈0.05）. The immune indexes had no significant differences between complete virological response group and partial/none virological response group （P〉0.05）. Except for higher levels of ALT and AST before antiviral therapy（P〈0.05） ,the immune indexes of e antigen seroconversion group did not have significant differences with those of un-e antigen seroconversion group （P〉0.05）. Conclusion The immune states of CHB patients have certain relationship with HBV virus load,and the counts of CD3^＋ T cell, CD4^＋T cell and CD8^＋T cell gradually incr.eased accompanied by virus load elevating, while the ratio of CD4^＋/CD8^＋ gradually declined with it. Nevertheless, the initial immune states before antiviral therapy have nothing to do with virological response or e antigen sero- conversion.
出处
《成都医学院学报》
CAS
2015年第4期400-403,共4页
Journal of Chengdu Medical College
基金
四川省感染科青年医师临床科研课题
关键词
慢性乙肝
免疫
病毒载量
抗病毒治疗
Chronic hepatitis B
Immune
Virus load
Antiviral therapy
