拉米夫定对慢性乙肝患者IL-2和IL-4影响的初步探讨

目的通过拉米夫定快速抑制病毒复制从而降低血清中HBV DNA含量来观察慢性乙型肝炎患者体内代表Th淋巴细胞免疫功能的免疫细胞因子IL-2和IL-4能否恢复。方法79例慢性乙型病毒性肝炎患者给予口服拉米夫定,每日1次,每次100mg,疗程1年。在拉米夫定治疗前和治疗期间第3、6、12个月抽血检查HBV DNA、肝功能、乙肝二对半、IL-2和IL-4。结果完全应答组拉米夫定治疗期间IL-2升高,IL-4降低,且治疗期间各时间点同治疗前相比有统计学意义(P<0.05);部分应答组治疗期间IL-2升高,IL-4降低,但前者仅治疗第3、6个月同治疗前相比有统计学意义(P<0.05);后者仅治疗第3个月同治疗前相比有统计学意义(P<0.05);无应答组治疗期间IL-2、IL-4含量同治疗前相比均无统计学意义(P>0.05);细胞因子含量和病毒含量这二者之间的改变有一定的联系。结论拉米夫定通过降低慢性乙型肝炎患者体内的病毒含量能够恢复代表辅助性T淋巴细胞免疫功能的免疫细胞因子IL-2和IL-4。

Discussion of effect of lamivudine treatment on IL - 2 and IL - 4 in chronic hepatits B

Objective To investigate whether lamivudine treatment that potently inhibits HBV DNA synthesis and rapidly suppresses serum HBV DNA levels in patients with chronic hepatitis B can restore IL-2 and IL-4 levels.Methods Seventy nine patients with chronic hepatitis B were treated with 12 months of 100 mg, of lamivudine orally once a day. Before and at 3,6 and 12 months during lamivudine therapy, peropheral blood serum from 79 patients with chronic hepatitis B receiving lamivudine treatment were isolated routinely. At each assessment, patients were evaluated for HBV DNA, HBe Ag, anti-HBe. ALT,IL-2 and IL-4.Results In patients fully responding to lamivudine, the level of IL-2 increased and the level of IL-4 decreased. They were statistical difference as compared with those before therapy(P<0.05). In patients partially responding to lamivudine, the level of IL-2 increased. It was only statistical difference at 3 and 6 months as compared with those before therapy(P<0.05).The level of IL-4 decreased. It was only statistical difference at 3 months as compared with those before therapy(P<0.05). The change of cytokines levels was associated with the decline of serum HBV DNA. Conclusion Lamivudine treatment that rapidly suppresses serum HBV DNA levels in patients with chronic hepatitis B can restore IL-2 and IL-4 levels.