乙酰半胱氨酸联合肝苏片对重型乙肝患者免疫功能的影响

Effects of acetylcysteine combined with Gansu tablets on immune function of patients with severe hepatitis B

目的探讨利用乙酰半胱氨酸联合肝苏片对重型乙肝患者临床治疗效果以及免疫功能的影响。方法将2016年2月至2017年4月收诊的90例重型乙肝患者平均分成试验组和对照组,每组45例。对照组给予常规护理和乙酰半胱氨酸对症治疗,试验组在此基础上增用肝苏片治疗,2组患者均治疗4个疗程,1个疗程14d。观察2组在治疗前后外周血T淋巴细胞(CD3^+、CD4^+、CD8^+)、NK细胞、肝功能指标、凝血指标、血浆氨以及血清炎性指标(hs-CRP、TNF-α、IL-6、IL-8)的变化情况,并评价2组患者临床治疗效果。结果治疗前,2组患者外周血T淋巴细胞(CD3^+、CD4^+、CD8^+)、NK细胞、肝功能指标(ALT、AST、TBA、TB)、凝血指标(PTA、PT)、血浆氨以及血清炎性指标(hs-CRP、TNF-α、IL-6、IL-8)水平差异无统计学意义(P>0.05),治疗后,2组患者T淋巴细胞、NK细胞、肝功能指标、凝血指标、血浆氨及血清炎性指标水平均得到有效改善,且试验组患者各项指标改善程度均显著优于对照组(P<0.05);试验组和对照组总有效率分别为82.22%、62.22%,差异有统计学意义(P<0.01)。结论乙酰半胱氨酸联合肝苏片对重型乙肝患者具有较好的临床治疗效果,能更好的减轻患者体内炎性因子水平,调节重型乙肝患者体内免疫功能,促进患者预后,具有积极的临床意义。

Objective To explore the effects of acetylcysteine combined with Gansu tablets on clinical efficacy and immune function of patients with severe hepatitis B.To explore the effect of acetylcysteine combined with gansu tablets on the curative therapy and immune function of patients with severe hepatitis B.Methods Ninety patients with severe hepatitis B who were admitted and treated in our hospital from February 2016 to April 2017 were divided into the experimental group and the control group,with 45 cases in each group.The patients in the control group received conventional care and symptomatic treatment with acetylcysteine,while those in the experimental group were treated with Gansu tablets.The two groups were treated for 4 courses(14 days for each course).Peripheral blood T lymphocytes(CD3^+,CD4^+,CD8^+),NK cells,liver function indexes,blood coagulation indexes,plasma ammonia and serum inflammatory indexes(hs-CRP,TNF-α,IL-6 and IL-8)were observed before and after treatment.The clinical efficacy of the two groups were evaluated.Results Before treatment,there were no significant differences in the levels of peripheral blood T lymphocytes(CD3^+,CD4^+,and CD8^+),NK cells,liver function indexes(ALT,AST,TBA,and TB),blood coagulation indexes(PTA,and PT),plasma ammonia and serum inflammatory indexes(hs-CRP,TNF-α,IL-6,IL-8)between the two groups(P>0.05).After treatment,the levels of T lymphocytes,NK cells,liver function indexes,blood coagulation indexes,plasma ammonia and serum inflammatory indexes were effectively improved in both groups,and the improvement degree in experimental group was superior to in control group(P<0.05).The total effective rate in experimental group and the control group was 82.22%and 62.22%,respectively,and the difference was statistically significant(P<0.01).Conclusion Acetylcysteine combined with Gansu tablets has better clinical effects in treatment of severe hepatitis B,which can better reduce the levels of inflammatory cytokines in patients,regulate the immune function,and promote the prognosis of patients.Therefore,it has positive clinical significance.