慢性乙型肝炎患者拉米夫定治疗前后SIL-2R、TNF和T淋巴细胞亚群的变化

The changes of the concentration of soluble interleukin-2 reciptors,tumor necrosis factor and T lymphocyte subsets in patients with chronic hepatitis B after lamivudine therapy

目的 研究拉米夫定对慢性乙型肝炎患者SIL 2R(可溶性白细胞介素 2受体 )、TNF(肿瘤坏死因子 )和T淋巴细胞亚群的影响。方法 分别用双抗体夹心酶联免疫法测血清SIL 2R、放射免疫法测血清TNF和单克隆抗体免疫技术测定T淋巴细胞亚群 ,比较拉米夫定治疗 35例慢性乙型肝炎患者治疗前后HBVDNA阴转率、ALT复常率、SIL 2R、TNF和T淋巴细胞亚群的变化。结果 治疗后HBVDNA阴转率为 86 .9% ,ALT复常率为 79.8% ,显著高于治疗前 (P <0 .0 1)。SIL 2R、TNF水平显著降低 (P <0 .0 5 )。T淋巴细胞亚群CD+ 4 、CD+ 4 /CD+ 8水平显著高于治疗前 (P <0 .0 1) ,CD+ 8显著低于治疗前 (P <0 .0 5 )。HBVDNA阴转者T细胞免疫功能优于未转者。结论 拉米夫定可改善慢性乙型肝炎的细胞因子水平和T细胞免疫功能 ,T细胞免疫功能紊乱较轻的患者 ,拉米夫定治疗的效果较好 ,SIL 2R、TNF及CD+ 4 /CD+ 8水平可以作为疗效判断的指标。这些指标在一定程度上反映了机体免疫功能状态和肝脏受损的程度 。

Objective To study the variety of the concentration of suluble interleukin 2 reciptor(SIL 2R),tumor necrosis factor(TNF) and T lymphocyte subsets in patients with chronic hepatitis B after lamivudine therapy.Methods Serum HBV DNA and the concentration of SIL 2R,TNF and T lymphocyte subsets were detected in patients with chronic hepatitis B(35 cases)before and after lamivudine therapy.Results The negative conversion of HBV DNA and the recovery rate of ALT after lamivudine therapy were 86.9% and 79.8% respectively,significantly higher than those before therapy.The concentration of SIL 2R and TNF were significantly decreased( P <0.05).CD + 4,the rato of CD + 4/CD + 8 rose obviously( P <0.01) and CD + 8 descened obviously( P < 0.05 ) after lamivudine therapy.Conclusion The cell immunologic function in patients with chronis hepatitis B treated with lamivudine could be mproved.