拉米夫定联合干扰素治疗乙型肝炎病毒感染患者临床疗效及对免疫功能的影响分析

Clinical effect of lamivudine combined with interferon on treatment of patients with hepatitis B virus infection and influence on immune function

目的探讨拉米夫定(LAM)与干扰素(IFN)联合治疗乙型肝炎病毒(HBV)感染的临床疗效及其对免疫功能的影响,为临床治疗HBV感染提供参考依据。方法选择2014年1月-2015年5月于医院进行治疗的HBV感染患者64例,将患者分为试验组31例和对照组33例;对照组患者采用常规治疗方法,试验组患者在对照组治疗的基础上再选用IFN与LAM联合进行治疗;检测患者治疗后HBeAg转阴情况以及HBV-DNA转阴情况,并在患者停药6个月后检测HBV-DNA反跳现象;患者治疗前、后各抽取空腹静脉血2ml,选择SAP法对患者CD_4^+、CD_8^+以及CD3+水平进行检测;采用SPSS17.0软件对数据进行统计分析。结果入选患者经治疗后血清总胆红素、转氨酶以及其他肝功能指标均得到改善,试验组HBeAg及HBV-DNA转阴率比对照组高,试验组患者6个月后HBV-DNA反跳率比对照组低,两组比较差异均有统计学意义(P<0.05);治疗前两组患者CD_8^+、CD_4^+及CD_4^+/CD_8^+平均值差异无统计学意义,治疗后试验组患者CD_8^+、CD_4^+及CD_4^+/CD_8^+平均值与对照组患者比较,差异均有统计学意义(P<0.05)。结论 HBV感染患者采用LAM联合IFN进行治疗的临床疗效显著,可提高患者自身免疫力,值得在临床推广应用。

OBJECTIVE To explore the clinical effect of lamivudine（LAM）combined with interferon（IFN）on treatment of patients with hepatitis B virus（HBV）infection and observe the influence on immune function so as to provide guidance for clinical treatment of HBV infection.METHODS A total of 64 patients with HBV infection who were treated in the hospital from Jan 2014 to May 2015 were enrolled in the study and divided into the experimental group with 31 cases and the control group with 33 cases.The control group was given conventional therapy,while the experimental group was treated with additional IFN combined with LAM based on the treatment of the control group.The negative rates of HBeAg and HBV-DNA were determined after the treatment,and the bounce rate of HBV-DNA was detected after the drug withdrawal for 6months.Totally 2ml of fasting venous blood was drawn from each patient before and after the treatment,the levels of CD_4^＋,CD_8^＋,and CD3^＋were detected by using SAP method,and the statistical analysis of data was performed with the use of SPSS17.0software.RESULTS The serum total bilirubin,transaminase,and other liver function indicators of the enrolled patients were improved after the treatment.The negative rates of HBeAg and HBV-DNA of the experimental group were higher than those of the control group,and the bounce rate of HBV-DNA of the experimental group was lower than that of the control group after the drug withdrawal for 6months,and there was significant difference between the two groups（P〈0.05）.There was no significant difference in the average level of CD_8^＋,CD_4^＋,or CD_4^＋/CD_8^＋between the two groups of patients before the treatment;there was significant difference in the average level of CD_8^＋,CD_4^＋,or CD_4^＋/CD_8^＋between the experimental group and the control group after the treatment（P〈0.05）.CONCLUSION LAM combined with IFN can achieve significant clinical effect on treatment of the patients with HBV infection and boost the immunity of the patients,and it is worthy to be promoted in the hospital.