自身CD3AK细胞与拉米夫定联合治疗乙型肝炎的临床观察

CLINICAL OBSERVATION OF TREATING PATIENT WITH CHRONIC HEPATITIS BUSING LAMIVUDINE COMBINED WITH CD3AK CELLS

目的 :探讨拉米夫定与CD3AK细胞联合治疗慢性乙型肝炎的临床治疗效果。方法 :将 73例慢性乙型肝炎患者随机分为两组。 5 8例患者接受CD3AK细胞治疗 (1疗程回输细胞总数为 1.1- 8× 10 10 )和每天服用拉米夫定 10 0mg ,15例每天单纯服用拉米夫定 10 0mg。结果 :73例患者经 12个月治疗后 ,拉米夫定和CD3AK细胞联合治疗组与单用拉米夫定治疗组HBVDNA转阴率分别为 86 .2 %和 80 .0 % ,无显著差异。但联合治疗组HBeAg阴转率、eAb转换率、ALT复常率显著高于单拉米夫定治疗组 (分别为 5 2 .6 %vs 14 .3% ,2 0 .7%vs7.1%和 97.2 %vs 84 .6 % )。联合治疗组CD3和CDST淋巴细胞绝对值在CD3AK细胞治疗后均增加在 85 %以上。结论 :拉米夫定联合自身CD3AK细胞过继免疫治疗乙型肝炎可有效提高患者HBeAg阴转率和ALT的复常率 ;能明显增强患者的细胞免疫功能 ;缩短拉米夫定对慢性乙型肝炎治疗疗程。

Objective:To evaluate the effect of the treatment of chronic hepatitis B with lamivudine combined with CD3AK cells.Methods: 73 patients with chronic hepatitis B as defined by positive HBeAg and HBVDNA and elevated ALT were enrolled and randomized into lamivudine combined with CD3AK cells group and lamivudine group. 58 patients received lamivadine 100mg daily and the numbers of transferred CD3AK cells per patient were 1.1-8×10 10 in one course of treatment, and 15 patients only received lamivudine 100mg daily.Results:The efficacy and safety were evaluated with clinical, biochemical, and virological parameters. After 12 months treatment, HBV-DNA response (serum HBV DNA negative) rate has no difference between tamivudine combined with CD3AK cells group and lamivudine group: (86.2% vs 80.0%, P>0.05).However, HBeAg negative rate was higher in lamivudine combined with CD3AK cells group than lamivudine group: (52.6% vs 14.3%,P<0.01), ALT normalization rate in lamivudine combined with CD3AK cells group was higher than lamivudine group (92.2% vs 84.6% ,P<0.05). The absolute members of CD3 and CD8T cells increased to over 85% after being treated with lamivudine combined with CD3AK cells.Conclusions:Lamivudine combined with CD3AK cells can significantly enhance cellular immune functions ,HBeAg negative rate and ALT normalization rate, then the treatment course of lamivudine in chronic hepatitis B would be shortened.