抗HBV-树突状细胞联合恩替卡韦治疗慢性乙型肝炎疗效观察

Clinical observation on the effects of combined treatment of dendritic cells activated by HBsAg and entecavir on patients with chronic hepatitis B

目的观察HBsAg致敏自体外周血单个核细胞(PBMC)来源的树突状细胞(抗HBVDCs)联合恩替卡韦对慢性乙型肝炎(CHB)的治疗效果。方法 104例CHB患者随机分成治疗组(抗HBV-DCs联合恩替卡韦治疗,51例)和对照组(恩替卡韦治疗,53例),比较患者肝功能、HBV DNA、HBeAg的变化。结果治疗组HBV DNA低于检测下限的比率与对照组差异无统计学意义(P>0.05),但治疗组HBeAg阴转率(35.3%)、HBeAg血清学转换率(31.4%)以及ALT复常率(84.3%)均明显高于对照组(分别为22.6%、17.0%及71.7%),治疗组治疗6个月时,其HBV DNA低于检测下限的比率(66.7%)、HBeAg转阴率(35.3%)、HBeAg血清学转换率(31.4%)以及ALT复常率(84.3%)显著高于治疗3个月时(分别为35.3%、19.6%、11.8%及68.6%),差异均具有统计学意义(P<0.05)。结论抗HBV-DCs联合恩替卡韦治疗CHB较单用恩替卡韦疗效更佳。

Objective To investigate the therapeutic effects of the combination of dendritic cells （DCs） sensitized by HBsAg and entecavir （ETV） in the treatment of patients with chronic hepatitis B （CHB）. Methods Total of 104 CHB patients were randomly divided into treatment group （51 cases） and control group （53 cases）. Patients in treatment group were treated with oral ETV administration and dendritic cells sensitized by HBsAg injection, while those in control group were treated only with ETV. During the treatment, liver function, HBV DNA level and HBV markers were compared between the two groups, respectively. Results The HBV DNA undetectable rate was not signifcantly different between the treatment group and control group （P 〉 0.05）. But the rates of HBeAg negative （35.3%）, HBeAg seroconversion （31.4%） and ALT normalization （84.3%） of patients in treatment group were signiifcantly higher than those in control group （22.6%, 17.0%and 71.7%, respectively） （P〈0.05）. The above indexes in treatment group at the end of 6th month were also signiifcantly higher than those at the end of 3rd month （66.7%vs 35.3%, 35.3% vs 19.6%, 31.4% vs 11.8%, 84.3% vs 68.6%, respectively） （P〈 0.05）. Conclusions Combined treatment of DCs sensitized by HBsAg and ETV had better curative effects on CHB patients compared with ETV monotherapy.