【摘要】 目的 探讨慢性乙型肝炎（CHB）患者接受阿德福韦酯抗病毒治疗前外周血CD₄⁺、CD_25+-调节性T细胞（Treg细胞）水平与抗病毒远期临床疗效的关系。方法 选取具有抗病毒治疗适应证、核苷类似物初治的CHB患者为病例组（92例）,另选取性别、年龄相匹配的10例健康者为对照组。采用流式细胞技术检测人选对象外周血Treg细胞水平。病例组给予阿德福韦酯10 mg/d抗病毒治疗,定期检测乙型肝炎病毒标志物、HBV DNA及肝功能等。结果 治疗48周时,完全应答、部分应答和无应答者分别为11、69、12例。治疗前病例组外周血Treg细胞水明显高于对照组[（8.2±5.2）%比（3.0±0.7）%,P<0.05]。无应答组外周血Treg细胞水明显高于部分应答组、完全应答组和对照组[（11.6±1.6）%比（5.6±1.3）%、（3.6±0.8）%、（3.0±0.7）%,P<0.01];部分应答组外周血Treg细胞水明显高于完全应答组和对照组（均P<0.01）;完全应答组和对照组差异无统计学意义（P>0.05）。结论 CHB患者阿德福韦酯抗病毒治疗前外周血Treg细胞水平对阿德福韦酯抗病毒的远期疗效可能有一定的预测价值。更多还原

【Abstract】 Objective To investigate the relation between levels of regulation T cells(Treg cells) of peripheral blood in chronic hepatitis B(CHB) patients before receiving adefovir dipivoxil(ADV) antiviral therapy and the long-term clinical antiviral efficacy.Methods CHB patients with antiviral therapeutic indications and initial treatment of nucleoside analogues were selected as the case group;healthy subjects served as the control group.The levels of Treg cells of peripheral blood in the case group before receiving ADV antiviral therapy and the control group were detected by flow cytometry.The case group was given ADV 10 mg/d antiviral treatment and examined regularly on HBV markers,HBV DNA and liver function etc.Results All 92 cases were divided into complete response,response and nonresponse on the basis of its efficacy.The levels of peripheral Treg cells in the 92 cases before receiving ADV antiviral therapy was significantly higher than those in the control group[(8.23±5.2)%vs(3.0±0.7)%,P <0.05].The levels of peripheral Treg cells in the no response group was significantly higher than those in the partial response group,the complete response group and the control group[(11.6±1.6)%vs(5.6±1.3)%,(3.6±0.8)%,(3.0±0.7)%](P<0.01).Those in partial response group was significantly higher than those in healthy control group(P <0.01).But the levels of Treg cells in the complete response group and the control group were not significantly different(P > 0.05).Conclusion Levels of Treg cells of peripheral blood in CHB patients before receiving ADV antiviral therapy have some predictive value for the long-term efficacy of ADV antiviral treatment.更多还原