核苷酸类抗病毒药物治疗对乙型肝炎患者肝脏血流动力学参数及血清Th1/Th2型细胞因子水平的影响

Effects of long term treatment with nucleoside antiviral drugs on hepatic hemodynamics and serum Th1/Th2 cytokine levels in patients with hepatitis B

目的:探讨核苷酸类抗病毒药物长期治疗对乙型肝炎患者肝脏血流动力学参数及血清Th1/Th2型细胞因子水平的影响。方法:选取76例乙型肝炎患者,根据治疗方案的不同,将其分为对照组(35例)与观察组(41例)。对照组患者接受常规乙型肝炎临床治疗,不服用核苷酸类似物;观察组患者在常规治疗的基础上长期口服核苷酸类抗病毒药物;比较两组患者治疗前、后肝脏血流动力学指标以及血清辅助T淋巴细胞1和辅助T淋巴细胞2(Th1/Th2)型细胞因子水平变化。结果:1两组患者治疗后其肝脏血流动力学指标以及肝内循环时间(HV-HA)相比均明显改善,但观察组患者改善效果更为显著,与对照组相比差异显著,具有统计学意义(t=1.253,t=0.925,t=0.413,t=0.816,t=2.931,t=2.517,t=2.915;P<0.05);2两组患者治疗后白介素-4(IL-4)、白介素-6(IL-6)、γ干扰素(IFN-γ)及总胆红素等指标比较均明显改善,但治疗组患者各项指标改善效果更为显著,与对照组相比差异显著,具有统计学意义(t=1.957,t=1.681,t=2.041,t=2.113;P<0.05)。结论:长期应用核苷酸类抗病毒药物治疗乙型肝炎,可有效改善患者肝脏血流动力学指标,并可改善患者血清细胞因子水平,对提高患者肝功能、平衡乙型肝炎肝硬化患者细胞因子网络,调节机体免疫功能具有重要作用。

Objective：To investigate the effects of long-term treatment with nucleoside antiviral drugs on hepatic hemodynamics and serum Th1/Th2 level in patients with hepatitis B.Methods： 76 cases of hepatitis B patients admitted to our hospital from January 2015 to December 2015 were selected as the research objects. According to the treatment of patients with program divided into control group and observation group, control group （35 cases） patients received routine hepatitis B clinical treatment, but not taking nucleotide analogues, and observation group （41 cases） of patients in the conventional treatment based on long-term oral nucleotide antiviral drugs were compared between the two groups before and after treatment in patients with liver hemodynamics and serum Th1/Th2 helper T lymphocyte, T1/T helper 2 type cytokines level changes.Results： The PVV, PVD, PVCL, HV-DI, HAAT, HV-HA index of two groups of patients before treatment, showed no significant difference, but after treatment were significantly improved. However, the effect of the observation is more significant and the differences were statistically significant （t=1.253, t=0.925,t=0.413,t=0.816,t=2.931,t=2.517,t=2.915;P〈0.05）. The IL-4, IL-6, IFN-gamma, TBil and other indicators of two groups of patients before treatment, were no significant differences, but after treatment, the indexes were significantly improved. The indicators in the treatment group were improved more significantly. The differences were statistically significant （t=1.957,t=1.681,t=2.041,t=2.113;P〈0.05）.Conclusion： The long-term nucleotide antiviral drugs in the treatment of chronic hepatitis B can effectively improve the indicators of liver hemodynamics, improve the serum level of cytokines in patients. It plays an important role in improving the liver function, balancing the cirrhosis cytokines network with hepatitis B patients, and regulating immune function.