阿德福韦酯对慢性乙肝患者血清Thl／Th2类细胞因子、肝功能及HBV DNA复制的影响

目的研究阿德福韦酯对慢性乙肝患者血清Thlfrh2类细胞因子、肝功能及HBVDNA复制的影响机制。方法100例慢性乙肝患者随机分为观察组（阿德福韦酯＋常规治疗）和对照组（常规治疗）各50例，比较两组的疗效及治疗前后IFN-γ、IL-4、IFN-γ／IL-4及肝功能、HBVDNA复制、应答情况。结果观察组的疗效明显高于对照组，观察组和对照组IFN-γ、IFN-γ／IL-4治疗后均较治疗前明显升高，IL-4较治疗前明显降低，ALT、TBil治疗后均较治疗前明显降低，ALB较治疗前明显升高，且观察组较对照组变化更显著（P〈0．05）。治疗12周、16周、24周、36周、48周时，观察组HBVDNA≤105拷贝，mL、HBVDNA〈104拷贝／mL均明显多于对照组。治疗16周以后，观察组HBVDNA〈103拷贝／mL多于对照组。治疗12周、16周时，观察组和对照组均无完全应答，但观察组部分应答比例明显高于对照组。治疗24周、36周、48周时，观察组完全应答和部分应答比例均明显高于对照组。结论阿德福韦酯治疗慢性乙肝疗效确切，能明显抑制HBV复制，促进A¨复常，且还能通过免疫调节作用抑制病毒复制，值得临床推广和应用。

The effects of Adefovir dipivoxil on serum Th1/Th2 cytokines,liver function and HBV DNA replication in chronic hepatitis B patients

Objective To explore the effects and mechanisms of Adefovir dipivoxil on serum Th1/Th2 cytokines,liver function and HBV DNA replication in chronic hepatitis B patients.Methods One hundred cases chronic hepatitis B were randomly divided observation group(adefovir dipivoxil conventional treatment) and control group(conventional therapy) of 50 cases each,the efficacy and IFN-γ,IL-4 and IFN-γ/IL-4 and liver function,HBV DNA replication,response situation were compared.Results The efficacy of observation group was significantly higher than the control group,IFN-γ and IFN-γ/IL-4 after treatment were increased than before treatment,but IL-4 was significantly lower,ALT significantly reduced,TBil was significantly higher,and the observation group changed than the control group more significant(P<0.05).Treated for 12 weeks,16 weeks,24 weeks,36 weeks,48 weeks,HBV DNA ≤105 copies/mL and HBV DNA <104 copies/mL of the observation group were significantly more than the control group.Treated for 16 weeks,HBV DNA<103 copies/mL of the observation group was more than the control group.Treated for 12 weeks,16 weeks in the observation group and control group,there was no complete response,partial response ratio of the observation group was significantly higher.Treatment for 24 weeks,36 weeks,48 weeks in the observation group the complete response and partial response ratio were significantly higher.Conclusion The exact efficacy of adefovir treatment of chronic hepatitis B can significantly suppress HBV replication,and promote the normalization of ALT,and can inhibit viral replication by immune regulation,and it is worthy of promotion and application.