阿德福韦酯对慢性乙型肝炎患者Th1/Th2型细胞因子和肝纤维化指标的影响

目的探讨阿德福韦酯抗病毒治疗对慢性乙型肝炎患者肝纤维化的临床疗效及对外周血Thl/Th2细胞因子的影响。方法将60例慢性乙型肝炎患者随机分为治疗组和对照组,各30例。治疗组患者给予口服阿德福韦酯10 mg/次/d,共同48周,对照组采用常规治疗方法。采用放射免疫法测定2组患者治疗前后血清中肝纤维化指标HA、ⅣC、PCIII和LN的水平;采用DAS ELISA法检测2组患者治疗前后血清中细胞因子IFN-γ、IL-4水平。结果治疗组与对照组治疗前各项血清肝纤维化指标和血清中细胞因子IFN-γ、IL-4水平差异无统计学意义(P0.05);2组治疗后血清各项肝纤维化指标和细胞因子IFN-γ、IL-4水平差异有统计学意义(P0.01)。结论慢性乙型肝炎患者外周血Th1/Th2细胞因子的水平与肝纤维化指标密切相关。阿德福韦酯除直接抑制病毒作用外,还可能通过免疫调节作用抑制病毒复制。

Effects of adefovir dipivoxil therapy on cytokines TH1/TH2 and hepatic fibrosis in patients with chronic hepatitis B

Objective To investgate the clinical effects of Adefovir Dipivoxil on hepatic fibrosis and peripheral blood Thl/Th2 cytokines in patients with chronic hepatitis B.Methods A total of 60 patients with chronic hepatitis B were randomly divided into therapy group(30) and control group(30).The patients in therapy group were treated with Adefovir Dipivoxil 10 mg/d for 48 weeks,and the patients in control group were treated normally.Radioimmunoassay method was used to detect the levels of HA、ⅣC、PCIII and LN in peripheral blood in all patients,and DAS ELASA was used to detect the levels of IFN-γ and IL-4.Results Before treatment,the hepatic fibrosis factors and IFN-γ、IL-4 levels showed no significant difference(P>0.05) in therapy group and control group;after treatment,the hepatic fibrosis factors and IFN-γ、IL-4 levels showed significant difference(P<0.01) in the two groups.Conclusion The level of cytokines Thl/Th2 in peripheral blood in patients with chronic hepatitis B correlates with the factors of hepatic fibrosis.Adefovir Dipivoxil not only plays a direct role in inhibiting virus,but also maybe through immune regulation inhibiting virus replication.