拉米夫定联合抗乙肝胎盘转移因子治疗慢性乙型肝炎疗效及对T淋巴细胞的影响

Influence of Lamivudine and Anti-HBV Placenta Transfer Factors on the Curative Effects and T Lymphocyte for Chronic Hepatitis B Virus Patients

目的探讨拉米夫定联合抗乙肝胎盘转移因子治疗慢性乙型肝炎疗效及对T淋巴细胞的影响。方法选择2021年1月至2022年1月南阳市中心医院收治的90例慢性乙肝患者,按照随机数字表法分为研究组与对照组各45例,两组患者均给予补充血浆、人血白蛋白,应用护肝、抗感染药物等常规对症治疗。对照组接受拉米夫定治疗,研究组使用拉米夫定及抗乙肝胎盘转移因子联合治疗。两组均持续治疗12周,比较治疗前后两组乙肝病毒标志物的阴转情况及肝功能指标[总胆红素(TBil)、天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)、总胆汁酸(TBA)],观察两组用药前后的免疫功能变化,并统计比较两组不良反应发生率。结果治疗前,两组乙肝病毒标志物各项指标比较,差异无统计学意义(P>0.05);治疗后,研究组HBV-DNA阴转、HBeAg阴转、HBeAg/抗-HBe人数占比明显高于对照组,差异有统计学意义(P<0.05)。治疗前,两组患者肝功能相关指标对比,差异无统计学意义(P>0.05);治疗后,研究组TBil、AST、ALT、TBA水平低于对照组,差异有统计学意义(P<0.05)。治疗前,两组T淋巴细胞亚群各指标比较,差异无统计学意义(P>0.05);治疗后,两组CD3^(+)、CD4^(+)水平及CD4^(+)/CD8^(+)值高于治疗前,CD8^(+)水平低于治疗前,且研究组的改善幅度大于对照组,差异有统计学意义(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)。结论拉米夫定联合抗乙肝胎盘转移因子对慢性乙肝的治疗效果显著,有利于改善肝功能指标,调节免疫功能水平,进一步提高患者的临床治疗效果,且具有一定安全性。

Objective To discuss the influence of lamivudine and anti-HBV placenta transfer factors on the curative effects and T lymphocyte for chronic hepatitis B virus patients.Methods A total of 90 patients with chronic hepatitis B admitted to Nanyang Central Hospital from January 2021 to January 2022 were selected and divided into the study group and the control group according to the method of random number table,with 45 patients in each group.The patients in both groups were given plasma supplementation,human albumin supplementation,liver protection,anti infection drugs and other conventional symptomatic treatment.The control group was treated with lamivudine,while the study group was treated with lamivudine and anti hepatitis B placental transfer factor.Both groups were treated continuously for 12 weeks.The negative conversion of hepatitis B B virus markers and liver function indicators[total bilirubin(TBil),aspartate aminotransferase(AST),alanine aminotransferase(ALT)and total bile acid(TBA)]were compared between the two groups before and after treatment.The immune function changes of the two groups before and after treatment were observed,and the incidence of adverse reactions of the two groups were statistically compared.Results Before treatment,the hepatitis B virus markers between study group and control group were not significantly different(P>0.05);After treatment,the The proportion of HBV-DNA negative,HBeAg negative,and HBeAg/anti-HBe in the study group were significantly higher than that in the control group,with significant differences(P<0.05);Before treatment,the liver function indicators between groups were not significantly different(P>0.05);After treatment,TBil,AST,ALT and TBA contents in the study group were even lower than control group,with significant differences(P<0.05);Before treatment,T lymphocyte subpopulation indexes between two groups were not significantly different(P>0.05);After treatment,CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)values for two groups were higher than before,CD8^(+)values for two groups were lower than before;the changing degrees in the study group were even higher than control group,with significant differences(P<0.05);The adverse drug rates between groups were not significantly different(P>0.05).Conclusion Lamivudine combined with antihepatitis B placental transfer factor has a significant therapeutic effect on chronic hepatitis B,which is conducive to improving the liver function index,regulating the level of immune function,and further improving the clinical treatment effect of patients,and has certain safety.