【摘要】 目的观察乙型肝炎表面抗原致敏的自体树突细胞联合阿德福韦酯(联合组)与单用阿德福韦(阿德福韦组)治疗前后慢性乙型肝炎(CHB)患者外周血干扰素γ(IFN-γ)和白细胞介素4(IL-4)的变化,对照观察其抗乙型肝炎病毒的免疫效应。方法用实时荧光聚合酶链反应法检测治疗前,治疗后4、12、24及48周末患者血清乙型肝炎病毒脱氧核糖核酸(HBV DNA)。利用双抗体夹心酶联免疫吸附测定法检测相应时间点的血清中IFN-γ和IL-4水平。结果 CHB患者丙氨酸转氨酶和天冬氨酸转氨酶治疗后两组间改善值基本相同;HBV DNA改善值联合组从治疗12周末起明显高于阿德福韦组(P<0.05),在治疗48周末两组改善值基本相同。联合组IFN-γ水平在24周达到高峰,联合组在12、24周末明显高于阿德福韦组(P<0.05),阿德福韦组IL-4在12、24周末较治疗前下降(P<0.05)。结论两种治疗均能使机体免疫部分恢复或增强,联合组有明显优势,这种作用可能是随着治疗后病毒载量下降和CD4+T淋巴细胞活性的重建而出现的。更多还原

【Abstract】 Objective To compare the antiviral inmumomodulatory effect of HBsAg sensitized alone autologous dendritic cells combined with adefovir dipivoxil and adefovir dipivoxil alone in patients with chronic hepatitis B(CHB).Methods At different time,before therapy,and 4,12,24 and 48 weeks after therapy,the serum hepatitis B virus deoxyribonucleic acid(HBV DNA) values were quantified by real time fluorescent polymerase chain reaction.The serum levels of interferon-gamma(IFN-γ) and interleukin-4(IL-4) of patients selected randomly were determined by specific-enzyme-linked immunosorbent assay.Results The serum levels of alanine aminotransferase and aspartate aminotransferase were similar between patients treated with the autologous dendritic cells combined with adefovir and those with adefovir dipivoxil alone.The serum HBV DNA level with the autologous dendritic cells combined with adefovir therapy decreased more quickly than that with adefovir therapy alone after 12 weeks of treatment(P<0.05),but the gap vanished at the end point of 48 weeks after treatment.The level of serum IFN-γ with the autologous dendritic cells combined with adefovir therapy reached a peak at 24 weeks,and its serum IFN-γ values were higher than those of adefovir alone group at 12 and 24 weeks(P<0.05),while serum IL-4 values of adefovir group were lower at 12 and 24 weeks than before therapy(P<0.05).Conclusion Both therapies partially improve or enhance the immunity of the patients with CHB.The immunity of patients with CHB can be enhanced by the antitiral effect of autologous dendritic cells combined with adefovir or adefovir alone,which may arise from the descent of viral load and the restoration of CD4+T cells activity.更多还原