替比夫定对慢性乙型肝炎血清IL-2和IL-6的影响

Influence of Telbivudine on serum IL-2 and IL-6 in chronic hepatitis B

目的研究替比夫定(LdT)治疗慢性乙型肝炎(CHB)患者52周的疗效及其对白介素-2(IL-2)、白介素-6(IL-6)的影响。方法 34例初治的E抗原阳性的患者(7例女性)每日服用LdT 600 mg 52周,据52周HBV-DNA结果分为应答组和应答不佳组,比较两组治疗前及治疗后12、52周IL-2、IL-6浓度(双抗体夹心ELIAS法)的变化,评价其与抗病毒疗效的相关性。结果应答组、应答不佳组各17例,基线时肝功、IL-2、IL-6无差异,HBsAg和HBV-DNA差异有统计学意义(P<0.05);LdT治疗后肝功均明显改善(P<0.05),HBsAg、HBeAg和HBV-DNA明显降低(P<0.01),IL-6均降低,但应答组降低明显(P<0.01),且伴有IL-2升高(P>0.05)。IL-6与转氨酶及HBV-DNA定量呈负相关(P<0.05)。结论 LdT治疗能改善肝功能和病毒学指标,部分纠正CHB患者的细胞因子失衡状态,基线转氨酶较高、HBsAg及HBV-DNA较低、IL-6较高者疗效较好。

Objective To observe the efficacy of telbivudine（LdT） treatment for 52 weeks on chronic hepatitis B（CHB） patients and its influence on serum interleukin-2（IL-2） and interleukin-6（IL-6）.Methods 34 hepatitis B e antigen（HBeAg） positive CHB patients（including 7 females） were enrolled and received LdT 600mg once daily for 52 weeks.All the patients were devided into two groups by HBV-DNA results at the end of the study.The patients with HBV-DNA undetected at week 52 were served as complete virological response（CVR） group,while the other patients with HBV-DNA detected were served as partial virological response（PVR） group.The levels of serum IL-2 and IL-6 were detected by ELISA and compared between the two groups at the baseline,12 weeks and 52 weeks after treatment.Then,we evaluated the relationship between the levels and the antiviral efficacy of LdT.Results At the end of the 52-week study,there were 17 patients achieved CVR,and 17 patients achieved PCR.There was no difference in the levels of transaminase、IL-2 and IL-6,but there was significant difference in the quantities of HBsAg and HBV-DNA（P0.05） at baseline between the two groups.The liver function was improved obviously（P0.05）,the concentration of IL-6 desreased gradually and the quantities of HBsAg、HBeAg and HBV-DNA decreased significantly（P0.01） after the treatment in all patients.However,compared with that of the patients who achieved PVR,the concentration of IL-6 and the quantities of HBeAg and HBV-DNA decreased more significantly（P0.01） and the concentration of IL-2 increased（P0.05） in the patients who achieved CVR.Further study suggested that the IL-6 concentration was negatively correlated with the transaminase and HBV-DNA levels（P0.05）.Conclusion LdT treatment can improve liver function and virology index of CHB patients,and partly correct the cytokines imbalance state,especially among the patients with higher transaminase and IL-6 levels,lower quantities of HBsAg and HBV-DNA at baseline.