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目的观察干扰素联合核苷类药物对乙型病毒性肝炎(乙肝)患者外周血T淋巴细胞亚群表达改变的相关性。方法将100例乙肝患者随机均分为2组,对照组单独服用拉米夫定(100 mg·d~(-1)),试验组用干扰素α2b(每次180μg,1次/周)联合拉米夫定治疗,疗程均1年。治疗前后,测量患者的T淋巴细胞亚群的表达情况、T淋巴细胞组织中核仁形成区嗜银蛋白(Ag NORs)含量、肝功能和乙型肝炎病毒(HBV)DNA水平。结果治疗后与治疗前比较,试验组患者的CD3、CD4水平和Ag NORs含量显著升高,CD8水平明显降低(P<0.05),但对照组无明显变化(P>0.05)。试验组患者疗效显著优于对照组,且治疗后试验组患者的谷丙转氨酶(ALT)水平、乙型肝炎e抗体(Hbe Ag)水平和HBV DNA水平明显低于对照组(P<0.05)。结论干扰素联合核苷类药物可以显著提高乙肝患者的疗效,对患者的细胞免疫活性有明显的增强作用。
Objective To observe the correlation between interferon and nucleosides in the changes of peripheral blood T lymphocyte subsets in patients with hepatitis B (hepatitis B). Methods 100 cases of hepatitis B patients were randomly divided into two groups, the control group taking lamivudine alone (100 mg · d -1), the experimental group with interferon α 2b (each 180 μg, 1 / week) combined Lamivudine treatment, treatment 1 year. Before and after treatment, the expression of T lymphocyte subsets, the content of Ag NORs, the liver function and the level of hepatitis B virus (HBV) DNA in T lymphocytes were measured. Results Compared with those before treatment, the levels of CD3, CD4 and AgNORs in the experimental group were significantly increased, while the levels of CD8 were significantly decreased (P <0.05), but there was no significant change in the control group (P> 0.05). The efficacy of the test group was significantly better than that of the control group. After treatment, the levels of ALT, Hbe Ag and HBV DNA in the experimental group were significantly lower than those in the control group (P <0.05). Conclusion Interferon combined nucleoside drugs can significantly improve the efficacy of hepatitis B patients, the cellular immune activity in patients with significant enhancement.