恩替卡韦联合异甘草酸镁注射液对慢性乙型肝炎患者血清IL-2、IL-10、IL-17、MIF及外周血T细胞亚群水平的影响

Influence of Entecavir Combined with Magnesium Glycyrrhizin Injection on the serum IL-2, IL-10, IL-17, MIF, Levels and Peripheral Blood T Cell Subgroups of patients with Chronic Hepatitis B

目的:探讨恩替卡韦联合异甘草酸镁注射液对慢性乙型肝炎患者血清白细胞介素-2(IL-2)、白细胞介素-10(IL-10)、白细胞介素-17(IL-17)、巨噬细胞移动抑制因子(MIF)及外周血T细胞亚群水平的影响。方法:选择我院2015年6月~2016年12月收治的92例慢性乙型肝炎患者,并按不同治疗方式分为对照组与研究组,每组46例。对照组采用恩替卡韦治疗,研究组基于对照组加以异甘草酸镁注射液治疗。比较两组的临床疗效,治疗前后血清IL-2、IL-10、IL-17、MIF、谷丙转氨酶(ALT),谷草转氨酶(AST),总胆红素(TbiL)水平,外周血CD3^+、CD4^+、CD8^+、CD4^+/CD8^+的变化及不良反应的发生情况。结果:治疗后,研究组总有效率高于对照组[93.47%vs.71.74%],差异有统计学意义(P<0.05);两组血清IL-2水平及外周血CD3^+、CD4^+、CD4^+/CD8^+水平均较治疗前显著上升,且研究组以上指标均明显高于对照组,两组血清IL-10、IL-17、MIF、ALT、AST、TbiL水平及外周血CD8^+水平均较治疗前显著下降,且研究组以上指标均明显低于对照组,差异均有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论:恩替卡韦联合异甘草酸镁注射液对慢性乙型肝炎患者的效果优于单用恩替卡韦,可能与其显著升高血清IL-2、外周血CD3^+、CD4^+、CD4^+/CD8^+水平及降低血清IL-10、IL-17、MIF和外周血CD8^+水平有关。

Objective： To research the influence of entecavir combined with magnesium glycyrrhizin injection on the serum interleukin-2 （IL-2）,interleukin-10 （IL-10） and interleukin-17 （IL-17）, macrophage migration inhibitory factor （MIF） levels and peripheral blood T cell subgroups of patients with chronic hepatitis B. Methods： 92 cases of patients with chronic hepatitis B admitted from June 2015 to December 2016 were selected and divided into the control group and the research group according to different treatment method. The control group was treated with entecavir, while the research group was treated with magnesium glycyrrhizin injection based on the control group. The clinical curative effect, levels of serum IL-2, IL-10, IL-17, MIF, alanine aminotransferase （ALT）, aspertate aminotransferase （AST）, total bilirubin （TbiL）, peripheral blood CD3^＋, CD4^＋, CD8^＋, CD4^＋/CD8^＋ levels before and after treatment as well as the incidence of adverse reactions were compared between two groups. Results： After treatment, the total effective rate of research group was higher than that of the control group [93.47% vs. 71.74%] （P〈0.05）. The levels of serum IL-2, peripheral blood CD3^＋, CD4^＋, CD4^＋/CD8^＋ in both groups were significantly higher than those before treatment, which were higher in the research group than those of the control group, the serum levels of IL-10, IL-17, MIF, CD8^＋, ALT, AST, TbiL of both groups were lower than those before treatment, which were lower in the research group than those of the control group （P〈0.05）. No significant difference was found in the incidence of adverse reactions between two groups （P〉0.05）. Conclusion： Entecavir combined with magnesium isoglycyrrhizinate injection is more effective than the entecavir alone on the patients with chronic hepatitis B, it may be related to the significant increase of serum IL-2 expression, peripheral blood CD3^＋, CD4^＋, CD4^＋/CD8^＋ levels and decrease of serum IL-10, IL-17, MIF levels and peripheral blood CD8^＋ level.