【摘要】 目的探讨恩替卡韦联合拉米夫定与单用拉米夫定治疗慢性乙型肝炎患者后T细胞亚群和肝纤维化恢复情况的比较。方法选取2011年1月~2012年12月河北医科大学第一医院收治的慢性乙型肝炎患者96例,将其随机分为两组,研究组采用恩替卡韦联合拉米夫定治疗,对照组则单用拉米夫定进行治疗,两组疗程均为12个月。在各组治疗第3、6、9、12个月时分别检测T细胞亚群以及肝纤维化指标。结果与对照组相比,研究组患者在治疗后第3、6、9、12个月,外周血CD4+T细胞百分率显著上升,差异均有统计学意义(P<0.05);第6、9、12个月,外周血CD8+T细胞百分率显著下降,CD4+/CD8+比值上升,差异均有高度统计学意义(P<0.01);第3、6、9、12个月肝纤维化指标血清透明质酸、层粘连蛋白、Ⅳ型胶原和Ⅲ型前胶原肽四项指标均呈逐渐降低趋势,研究组各期均明显低于对照组,差异均有统计学意义(P<0.05)。结论恩替卡韦联合拉米夫定治疗慢性乙型肝炎,T细胞亚群和肝纤维化指标改善更显著,值得推广。更多还原

【Abstract】 Objective To observe the change of serum T-cell subsets and liver fibrosis markers in patients with chronic hepatitis B(CHB) treated with Lamivudine add-on Entecavir and Lamivudine monotherapy. Methods Ninety-six CHB patients admitted to the First Hospital of Hebei Medical University from January 2011 to December 2012 were selected and randomly divided into the study group and the control group. The study group was treated with Entecavir add-on Lamivudine for 12 months, and the control group was only treated with Lamivudine for 12 months. The T-cell subsets and serum liver fibrosis markers between two groups were detected respectively at the 3rd, 6th, 9th, 12 th month after treatment. Results Compared with the control group, levels of CD4+T cells in the study group were markedly higher at the 3rd, 6th, 9th, 12 th month after treatment, the differences were statistically significant(P < 0.05); levels of CD8+T cells in the study group were obviously lower(P < 0.05), and the ratios of CD4+/CD8+were markedly higher at the 6th,9th, 12 th month after treatment, the differences were statistically significant(P < 0.01); the levels of HA, LN, CⅣ and PCⅢ were indicated a gradually decreasing trend in the study group at 3rd, the 6th, 9th, 12 th month after treatment,these markers were all lower in the study group than those in control group, the differences were statistically significant(P < 0.05). Conclusion Lamivudine add-on Entecavir can improve the T-cell subsets and serum markers of liver fibrosis significantly in the treatment of chronic hepatitis B, and worthy of promotion.更多还原