阿德福韦酯对慢性乙型肝炎患者细胞因子水平的影响及与肝纤维化指标的相关性

Effect of Adefovir Dipivoxil therapy on cytokines TH_1/TH_2 and the correlation with the factors of hepafic cirrhosis in patients with chronic hepatitis B

【目的】探讨阿德福韦酯抗病毒治疗对慢性乙型肝炎患者外周血Th1/Th2细胞因子的影响及与其肝纤维化指标相关性。【方法】治疗组56例慢性乙型肝炎患者分成肝炎组及肝硬化组均给予口服阿德福韦酯10 mg/1次/d,共同48周,对照组40例两组进行比较。采用DAS-ELISA法检测患者IFN-γ、IL-4水平,用放射免疫法测定HA、CIV、PCⅢ和LN血清水平。【结果】治疗前后肝纤维化指标检测:阿德福韦酯治疗肝炎组、肝硬化组48周后分别与对照组比较,有显著差异,有统计学意义(P<0.01)。经过阿德福韦酯治疗48周后,肝炎组及肝硬化组的IFN-γ、IL-4的水平与对照组相比较,患者外周血培养上清PBMC中IL-4水平明显下降,而IFN-γ水平明显上升,差异有统计学意义(P<0.05)。【结论】慢性乙型患者外周血Th1/Th2细胞因子的水平与肝纤维化指标有密切相关。经阿德福韦酯抗病毒治疗48周后,通过对Th1/Th2细胞因子调节使肝纤维化指标与对照组比较有明显差异,在改善各项肝纤维化指标方面效果较好。

【Objective】To investgate the effect of Adefovir Dipivoxil therapy on cytokines Th1/ Th2 and the factors of hepatic cirrhosis in patients with chronic hepatitis B,and the relationships between cytokines Th1/Th2 and hepafic cirrhosis.【Methods】A total of 96 patients with chronic hepatitis B were randomly divided into therapy group（56） and control group（40）.In therapy group,patients were divided into hepatitis group and hepatic cirrhosis group and so in control group.The patients in therapy group were treated with Adefovir Dipivoxil 10 mg/d for 48 weeks,and the patients in control group were treated nomally.DAS ELASA was used to detect the levels of IFN-γ and IL-4 in peripheral blood in all patients,and radioimmunoassay method to detect the levels of HA,CIV,PCⅢ and LN.【Results】Before and after treatment with Adefovir Dipivoxil,the factors of hepafic cirrhosis in patients in therapy group（include of hepatitis group and hepafic cirrhosis group） had significant differenceao compared with control group respectively（P〈0.01）.The levels of IL-4 in PBMC in patients in the therapy group（include hepatitis group and hepafic cirrhosis group） decreased markedly, and the levels of IFN-γ increased markedlyao compared with control group respectively after Adefovir Dipivoxil therapy for 48 weeks（P〈0.05）.【Conclusions】The level of cytokines Th1/Th2 in peripheral blood in patients with chronic hepatitis B correlates with the factors of hepafic cirrhosis.The factors of hepafic cirrhosis have significant differenceao compared with control group by adjusting cytokines Th1/Th2 after Adefovir Dipivoxil therapy for 48 weeks and Adefovir Dipivoxil improve the factors of hepafic cirrhosis betterly.