摘要
目的:观察阿德福韦酯治疗前后慢性乙型肝炎患者外周血干扰素-γ(IFN-γ)和白细胞介素-18(IL-18)的变化,探讨阿德福韦酯抗乙型肝炎病毒(HBV)的免疫效应机制。方法:选择参加阿德福韦酯Ⅱ期临床试验的42例慢性乙型肝炎患者作为研究对象,检测阿德福韦酯治疗前、治疗4、12、24、48周末患者血清IFN-γ和IL-18水平,以及HBV DNA及ALT水平变化。结果:治疗前患者IFN-γ及IL-18水平明显高于正常对照组(P<0.01)。治疗后,HBV DNA水平逐渐降低,各检测时间点之间比较差异均有统计学意义(P<0.01),ALT在治疗4周时较治疗前有所升高(P<0.05),然后逐渐下降直至正常。IFN-γ及IL-18水平逐渐升高,在12周时达到高峰(P<0.01),然后逐渐降低。完全应答组治疗前INF-γ和IL-18水平高于部分应答组和无应答组(P<0.01)。完全应答和部分应答组治疗后INF-γ和IL-18水平与治疗前比较均明显升高(P<0.01),而无应答组IFN-γ和IL-18治疗前后比较,差异无显著性意义(P>0.05)。结论:阿德福韦酯除直接抑制病毒复制外,可促进Th1型细胞因子分泌,调动机体对HBV的细胞免疫,有利于HBV的清除。
Objective: To study the dynamic changes of IFN-γ and IL-18 in the serum of patients with chronic hepatitis B (CHB) treated with adefovir dipivoxil. Methods: Forty-two CHB patients (35 men and 7 women) were enrolled phase Ⅱ clinical trial of adefovir dipivoxil. At different time ( before therapy, and 4 weeks, 12 weeks, 24 weeks, 48 weeks after therapy), the serum level of IFN-γ and IL-18 of each patient were determined by specific-ELISA, and serum HBV DNA and ALT were also quantified by real-time fluorescent PCR and biochemical methods respectively. Results: The levels of IFN-γ and IL- l8 of patients with CHB were significantly higher than normal controls before therapy (P 〈 0.01 ). The levels of HBV DNA of patients decreased gradually after treatment with adefovir dipivoxil, but the levels of ALT increased at 4 weeks, and then decrease to normal value after therapy. The levels of IFN-γ and IL-18 increased and reached to peak at 12 weeks after therapy, and then decreased gradually. The levels of IFN-γ and IL-18 of patients in response group were significantly higher than that of non-response group before'and after therapy (P 〈0. 01 ). Conclusion: It is suggested that the cell immunity against HBV of patients with CHB can be enhanced by adefovir dipivoxil, which could benefit for elimination of HBV.
出处
《中西医结合肝病杂志》
CAS
2007年第6期330-332,共3页
Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases
基金
湖北省科技攻关计划课题基金资助(No.2005AA301C26)