阿德福韦对慢性乙型肝炎患者血清白介素-6、12和18水平的影响及疗效观察

Influence and efficacy of Adefovir on the levels of serum interleukin-6,12 and 18 in chronic hepatitis B patients

目的探讨阿德福韦对慢性乙型肝炎患者血清白介素(IL)-6、12和18水平的影响及疗效观察。方法选择70例慢性乙型肝炎患者,随机分为观察组和对照组。两组患者均予以门冬氨酸钾镁、还原型谷胱苷肽和复方甘草酸苷等常规保肝治疗。对照组加用干扰素α-2b治疗5 000 000 U,肌注,1次/d,10 d后改为隔日1次,连用6个月。观察组加用阿德福韦酯片10 mg/次,1次/d,连用6个月。观察两组患者治疗前后血清IL-6、IL-12、IL-18水平的变化,并进行抗病毒疗效比较。结果治疗6个月后,两组患者血清IL-6、IL-12、IL-18水平均有明显下降(P<0.01或P<0.05),且观察组比对照组下降的幅度更明显(P<0.05)。治疗6个月后,观察组抗病毒治疗的疗效明显高于对照组(χ2=4.16,P<0.05)。结论阿德福韦治疗慢性乙型肝炎的抗病毒治疗的疗效确切,能抑制细胞因子IL-6、IL-12、IL-18的作用,从而阻止肝纤维化的进展。

Objective To discuss the influence and efficacy of Adefovir on the levels of serum lnterleukin-6, 12 and 18 （IL-6, 12 and 18） in Chronic Hepatitis B （CHB） Patients. Methods 70 cases of CHB patients were selected and divided into observation group and control group at random. The patients in both groups were given conventional treatments such as potassium magnessium aspartate, reduced glutathione, compound glycyrrhizin etc. Additionally, the patients in observation group were given 10 mg Adefovir tablets once daily for 6 months, while those in control group were given interferon alfa-2b, 5 million units once daily for 10 days, then every other day for 6 months. The changes of serum IL-6, 12 and 18 levels of patients in both groups were observed before and after medical treatment, and the antiviral effect was compared. Results The serum IL6, 12 and 18 levels of patients in the two groups declined obviously after the treatment （ P 〈 0.01 or P 〈 0.05 ）, and the declining rate in observation group was much higher than that in control group （P 〈 0.05 ）. The antiviral effect in observation group was much better than that in control group （X2 = 4.16, P 〈 0. 05）. Conclusion Adefovir has reliable antiviral effect on CHB, which can inhibit the function of IL-6, 12 and 18, and prevent the development of hepatic fibrosis.