白细胞介素-2联合拉米夫定治疗慢性HBV感染疗效观察

The effect of combination therapy of IL-2 and barnivudine in chronic hepatitis B and chronic HBV carrires

目的观察IL-2联合拉米夫定治疗慢性乙型肝炎及慢性乙型肝炎病毒携带者的疗效。方法 47例慢性乙型肝炎患者中19例为联合治疗组,接受IL-2应用1个月后继用拉米夫定的治疗;28例患者为单独应用拉米夫定的对照组。21例肝功能正常的慢性乙型肝炎病毒携带者中11例接受IL-2联合拉米夫定的治疗;10例同样患者单独接受拉米夫定治疗。疗程均为12个月。结果慢性肝炎联合治疗和单用组,HBV-DNA阴转率于治疗后3、6、12个月,分别为78.9％、84.2％、78.9％和67.9％、67.9％、75.09％。治疗后12个月,两组HBeAg阴转率分别为33.3％和17.8％,E抗原血清转换率分别为29.4％和10.7％。联合治疗组明显高于单独治疗组。慢性乙型肝炎病毒携带者,联合或单独治疗组,HBV-DNA阴转率分别为66.7％和80％,未见HBeAg阴转和发生血清转换者。结论拉米夫定有抗乙型肝炎病毒的确切作用;对于慢性肝炎组,联合IL-2治疗较单独应用拉米夫定血清转换率更高。应用IL-2可使患者OKT4/OKT8比值升高,CT4细胞上升,其有明确的提高细胞免疫之作用。

Objective To observe the effect of combination therapy of IL - 2 and lamivudine in chronic hepatitis B and chronic HBV carriers.Methods 19 of 47 patients of chronic hepatitis B were treated with IL - 2 for one month, then with lamivudine for 11 months (therapy group); 28 with lamivudine for 12 months (control group) .11 of 21 patients of chronic HBV carriers were treated with IL-2 and lamivudine for 12 months (therapy group), 10 with lamivudine for 12 months (control group) .Results For chronic hepatitis B, the rate fir HBV - DNA clearance for three, six and twelve months were 78.9%, 84.2% and 78.9% respectively in combination therapy group; 67.9%, 67.9 and 75% in control group. After therapy for twelve months, the rate for HBeAg clearance were 33.3% in therapy group, 17.8% in control one; the rate for HBeAg alteration were respectively 29.4% and 10.7%.The effect of therapy group is better than control one.For chronic HBV carriers, the rate for HBV-DNA clearance were 66.7% and 80% respectively in therapy group and control one, there was not HBeAg clearance or alteration. Conclusion The antiviral effect of lamivudine in hepatitis B was positive.About chronic hepatitis, the effect of combination herapy of IL-2 and lamivudine was better than control group.After therapy with IL-2, the rate of OKT4/OKT8 was apparently higher than before, the effect of improving cellular immurtity of IL-2 was positive.