阿德福韦酯的临床疗效及其对CHB患者血清Th1／Th2型细胞因子的影响

目的观察阿德福韦酯治疗慢性乙型肝炎（CHB）近期临床疗效及其对CHB患者血清Th1／Th2型细胞因子的影响。方法采用自身对照、开放单一治疗的研究方法，选择40例明确诊断的CHB患者给予阿德福韦酯治疗，疗程48周，观察治疗前后症状、体征改善情况；检测肝功能（ALT、AST）、HBV—DNA、HBeAg和血清IL-4、IFN—γ的水平，并与同期健康体检者30例对照。结果40例CHB患者中，显效20例，有效17例，无效3例，总有效率92．5％；CHB组治疗后血清ALT、AST显著低于治疗前（P〈0．01），HBV-DNA水平明显下降（P〈0．01），HBeAg转阴率37．5％；CHB组治疗前血清IL-4水平明显高于健康对照组（P〈0．01），IFN-γ水平明显低于健康对照组（P〈0．01）；治疗48周后CHB组IL-4水平明显下降（P〈0．01），IFN-γ水平明显升高（P〈0．01）。结论阿德福韦酯治疗CHB近期临床疗效确切，患者依从性好，能纠正CHB患者Th1／Th2失衡状态，明显改善CHB患者肝功能和病毒学指标。

Clinical Effect of Adefovir Dipivoxil and Its Influence on Serum Th1/Th2 Type of Cytokines in CHB

Objective To observe the recently clinical effect of adefovir dipivoxil on chronic hepatitis B （CHB）and its .influence on serum Th1/Th2 type of cytokines. Methods Using self-reflection,open a single treatment research method,choose 40 patients with CHB who were treated with adefovir dipivoxil. After 48 weeks,improvement of symptoms and signs were observed,and ALT,AST, HBV-B,HBeAg and serum IL-d,IFN-γ level were detected. Serum IL-4,IFN-γ level were compared with the healthy control group. Results 40 patients with CHB,the markedly effective was 20 cases,the effective was 17 cases,the invalid was 3 cases;the total effective rate was 92.5%. After treatment,ALT,AST significantly below before treatment （P〈0.01）,HBV-B levels decreased obviously （P〈 0.01）,HBeAg shade rate 37.5%. Before treatment,serum IL-4 level of CHB group was obviously higher than healthy control group（P〈 0.01）,IFN- γ level obviously lower than healthy control group （P〈0.01）. After 48 weeks, IL-4 levels in CHB group decreased obviously（P〈0.01 ）,IFN-γ level increased significantly（P〈0.01）. Conclusion Adefovir dipivoxil recently clinical effect is obvious,Which can correct CHB patients Th1/Th2 unbalance state and improve liver function and irology index.