替诺福韦酯在慢性乙型肝炎合并胃溃疡患者中的应用及对宿主免疫应答

Tenofovir dipivoxil for treatment of chronic hepatitis B patients with gastric ulcer:Efficacy and impact on host immune response

目的探讨替诺福韦酯在慢性乙型肝炎(chronic hepatitis B,CHB)合并胃溃疡患者中的临床效果及对宿主免疫应答的影响.方法取2015-01/2016-10医院收治CHB合并胃溃疡患者60例,随机数字法分为对照组(n=30)和观察组(n=30).对照组采用阿德福韦酯治疗,观察组采用替诺福韦酯治疗,采用流式细胞仪对患者治疗前、后免疫水平进行测定,比较2组临床疗效及对宿主免疫的影响.结果 2组治疗48 wk病毒学突破率比较差异无统计学意义(P>0.05);观察组治疗48 wk ALT复常率、HBV DNA转阴率及HBeAg血清学转换率,高于对照组(P<0.05);观察组治疗后CD4^+、CD8^+、CD4^+/CD8^+比值,高于对照组(P<0.05).观察组不良反应发生率为10.00%,对照组为13.33%,2组治疗后药物不良反应发生率比较差异无统计学意义(P>0.05).结论 CHB合并胃溃疡患者采用替诺福韦酯治疗效果理想,能调节机体免疫,值得推广应用.

AIM To evaluate the clinical efficacy of tenofovir dipivoxil in chronic hepatitis B （CHB） patients with gastric ulcer and its effect on host immune response.METHODS From January 2015 to October 2015, 60 CHB patients with gastric ulcer were randomly divided into a control group （n =30） and an observation group （n= 30）. The control group was treated with adefovir dipivoxil, and the observation group was treated with tenofovir dipivoxil. The immune levels before and after treatment were measured by flow cytometry. The clinical efficacy and the effect on the host immune response were compared between the two groups.RESULT$ There was no significant difference in the rate of viral breakthrough between the two groups （P 〉 0.05）. The ALT normalization rate, HBV DNA negative convsersion rate and HBeAg seroconversion rate in the observation group were significantly higher than those in the control group （P 〈 0.05）. The percentages of CD4＋ and CD8＋ cells and CD4＋/CD8＋ratio in the observation group were significantly higher than those in the control group （P 〈 0.05）. The incidence of adverse reactions was 10.00% in the observation group and 13.33% in the control group. There was no significant difference in the incidence of adverse drug reactions between the two groups （P 〉 0.05）.CONCLUSION Tenofovir dipivoxil has good efficacy in CHB patients with gastric ulcer and can be used toregulate immunity.