复方鳖甲软肝片联合恩替卡韦片对慢性乙肝肝纤维化患者外周血Th17细胞表面CCR4、CCR6、CXCR3表达影响

Effect of Compound Biejia Ruangan tablets combined with Entecavir tablets on patients with chronic hepatitis B patients with fibrosis on the expression of CCR4,CCR6 and CXCR3 on Th17 cells surface in peripheral blood

目的探讨复方鳖甲软肝片联合恩替卡韦片对慢性乙肝肝纤维化患者外周血Th17细胞表面CCR4、CCR6、CXCR3表达量的影响。方法随机将94例慢性乙肝肝纤维化患者分为2组,对照组47例给予恩替卡韦分散片治疗,研究组47例给予复方鳖甲软肝片联合恩替卡韦分散片治疗,疗程均为48周。观察2组治疗前后血清HBV DNA、总胆红素(TBil)、谷丙转氨酶(ALT)、透明质酸(HA)、层黏连蛋白(LN)、Ⅳ型胶原(Ⅳ-C)和人Ⅲ型前胶原(PCⅢ)水平,CD4+Th17细胞表面趋化因子受体CCR4、CCR6、CCR3表达百分率及门静脉内径、脾脏厚度。结果治疗后2组ALT、TBil及Th17细胞表面CCR4、CCR6、CXCR3表达量均显著降低(P均<0.05),且观察组显著低于对照组(P均<0.05);2组血清HA、LN、Ⅳ-C、PCⅢ水平均显著降低(P均<0.05),且观察组显著低于对照组(P均<0.05);2组门静脉内径和脾脏厚度均显著降低(P均<0.05),且观察组显著低于对照组(P均<0.05);2组HBV DNA水平比较差异无统计学意义(P>0.05)。结论复方鳖甲软肝片联合恩替卡韦可改善患者肝功能,减轻肝纤维化程度,降低Th17细胞表面CCR4、CCR6、CXCR3表达可能是其重要作用机制。

Objective:It is to investigate the effect of Compound Biejia Ruangan tablets combined with Entecavir tablets on patients with chronic hepatitis B with fibrosis on the expression of CCR4,CCR6,CXCR3 on Th17 cells surface in peripheral blood.Methods 0x09 94 patients with chronic hepatitis B with fibrosis were randomly divided into 2 groups,47 cases in each.The patients were treated with Entecavir Dispersible Tablets in the control group,and with Compound Biejia Ruangan tablets combined with Entecavir Dispersible Tablets in the study group,the course of treatment was 48 weeks.The levels of serum HBV DNA,total bilirubin(TBil),alanine aminotransferase(ALT),hyaluronic acid(HA),laminin(LN),typeⅣcollagen(Ⅳ-C)and human typeⅢprocollagen(PCⅢ),the expression percentage of CD4+Th17 cell surface chemokine receptor CCR4,CCR6,CCR3,and the inner diameter of portal vein and spleen thickness in the 2 groups before and after treatment were observed.Results 0x09 After treatment,the expressions of CCR4,CCR6 and CXCR3 on the surface of Th17 cells and ALT,TBil were significantly lower than those before treatment in the two groups(all P<0.05),and the levels of the observation group was significantly lower than the control group(P<0.05);the serum levels of HA,LN,ⅣC and PCⅢwere significantly decreased than those before treatment in the two groups(all P<0.05),and the levels of the observation group was significantly decreased than the control group(P<0.05);the internal diameter of the portal vein and the thickness of the spleen were significantly lower than those before treatment in the two groups(all P<0.05),and the observation group were significantly lower than the control group(P<0.05).There was no significant difference in the levels of HBV DNA between the 2 groups after treatment(P>0.05).Conclusion 0x09 Compound Biejia Ruangan tablets combined with Entecavir tablets can improve the liver function,reduce the degree of liver fibrosis,reducing the expression of CCR4,CCR6 and CXCR3 on the surface of Th17 cells may be an important mechanism.