儿童慢性乙型肝炎细胞免疫功能及胸腺素疗效

目的　探讨慢性乙型肝炎(CHB)患儿细胞免疫功能及胸腺素疗效。方法　6 0例CHB患儿随机分为常规组(予常规治疗)和胸腺素组(在常规治疗基础上+胸腺素) ,并以6 0例健康儿童作为正常对照组。于治疗前、疗程结束后1mo检测T细胞亚群(CD+ 3 、CD+ 4 、CD+ 8)、血清白细胞介素2 (IL 2 )及可溶性白细胞介素2受体(sIL 2R)水平;定期复查肝功能、乙肝标志物和HBV DNA。结果　与正常对照组比较,CHB组CD+ 3 与CD+ 4 的百分率、CD+ 4 /CD+ 8及血清IL 2水平明显降低(P均<0 0 1) ,CD+ 8百分率及血清sIL 2R水平明显升高(P均<0 0 1) ;与常规组比较,胸腺素组血清ALT明显下降(P <0 0 1) ,ALT复常时间明显缩短(P <0 0 1) ,HBeAg转阴率明显上升(P <0 0 5 ) ,各免疫学指标明显恢复,差异均有统计学意义(P <0 0 1或P <0 0 5 )。结论　CHB患儿细胞免疫功能低下,胸腺素能增强细胞免疫功能,有利于病毒清除和肝功能的恢复

Study of immune mechanism of children's chronic hepatitis B and treating effect of thymosin

AIM To study the cellular immune function and mechanism of thymosin in children's chronic hepatitis B (CHB) and treating effect of thymosin. METHODS Sixty CHB children were divided into conventional and thymosin group randomly,and 60 healthy children were chosen as normal controls.T lymphocyte subsets ,levels of serum interleukin-2(IL-2) and soluble interleukin-2 receptor(sIL-2R) were determined both before and 1 mo after therapy.Hepatic function and virological analyses(HBeAg,HBV-DNA) were determined timely. RESULTS In CHB patients,the percentages of CD + 3 and CD + 4, ratios of CD + 4/ CD + 8 and levels of IL-2 decreased markedly,while the percentages of CD + 8 and levels of sIL-2R increased significantly compared with the normal controls(P<0.01).Patients treated with thymosin had a more significant increase in the percentages of CD + 4, ratios of CD + 4/ CD + 8 and levels of IL-2,a more significant decrease in the percentages of CD + 8 and levels of sIL-2R(P<0.05 or P<0.01) than conventional controls.The serum ALT levels dropped more markedly and quickly,and the HBeAg loss was obviously higher in thymosin group than in conventional controls(P<0.05). CONCLUSION Low cellular immune function and immune regulation disorders develop in CHB children,and thymosin is effective in viral clearance by enhancing cellular immune function and improving the balance of T cell subsets in CHB children.