【摘要】 目的探讨慢性乙肝患者接受替比夫定抗病毒治疗后血清T淋巴细胞亚群Th1/Th2细胞因子水平的变化及与肝功能ALT恢复、HBVDNA含量变化及血清HBeAg转换的关系。方法64例HBeAg(+)慢性乙肝患者接受替比夫定抗病毒治疗,ELISA法检测治疗前及治疗24W后Th1细胞因子IL-2、IL-12及Th2细胞因子IL-4、IL-10的血清浓度变化,并同时检测肝功能ALT、HBVDNA含量的变化及HBeAg血清转换率。结果64例HBeAg(+)慢性乙肝患者接受替比夫定治疗24W后,有55例患者ALT恢复正常,占85.9%,有34例HBVDNA<5×102copies/ml,HBeAg(-),占53.1%,治疗52W,有15例发生HBeAg血清学转换,比例为23.4%。治疗组患者血清Th1细胞因子水平低于对照组,Th2细胞因子水平高于对照组,替比夫定治疗后,HBeAg阴转及血清转换患者血清Th1细胞因子浓度比治疗前升高,Th2细胞因子浓度比治疗前降低均有统计学意义(P<0.05),ALT恢复正常,HB-VDNA含量下降显著(P<0.01)。结论T细胞亚群Th1/Th2细胞因子与慢性乙肝替比夫定抗病毒治疗后血清ALT复常,HBVDNA含量下降及HBeAg阴转及血清学转换相关,Th1/Th2亚群细胞因子平衡是促进肝功能ALT恢复、HBVDNA含量下降的重要因素之一,HBeAg高阴转及血清学转换率可能与替比夫定能上调Th1细胞因子水平有关。更多还原

【Abstract】 Objective To study the change in Th1/Th2 cytokines and its relationship with ALT,HBV DNA and HBeAg conversion in chronic hepatitis B (CHB) patients treated with telbivudine.Methods 64 HBeAg-positive CHB patients treated with telbivudine were included in the study.Th1cytokines (IL-2,IL-12) and Th2 cytokines (IL-4,IL-10) were measured by ELISA before treatment and at the 24th week after treatment.ALT and HBV DNA were evaluated at the same time.Results 86% of the patients showed normal ALT and 53% had undetectable serum HBVDNA level after 24 weeks of treatment.The HBeAg conversion rate was 23.4% at the 52nd week of treatment.The level of Th1 cytokines in the treatment group was higher and Th2 cytokines was lower than that of the control group.There was a significant difference between pre-treatment and post-treatment cytokine levels (p<0.05).Serum HBV DNA and ALT levels were decreased dramatically with the antiviral therapy.Conclusion There is a significant correlation between serum cytokine level,ALT and HBV DNA in CHB patients treated with telbivudine.The balance between Th1/Th2 cytokines may contribute towards normal ALT,undetectable HBV DNA and HBeAg serum conversion.更多还原