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您现在的位置:首页 => 在线期刊 => 2019年 11期“中国肝移植的发展与创新” => 病毒性肝炎 =>慢性乙型肝炎患者抗病..
慢性乙型肝炎患者抗病毒治疗后T淋巴细胞受体重排删除环水平的变化
Change in the level of T-cell receptor rearrangement excision circles after antiviral therapy in patients with chronic hepatitis B
文章发布日期:2019年09月29日  来源:  作者:熊芳, 马艳品, 鲍旭丽, 等  点击次数:212次  下载次数:48次

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【摘要】: 目的 观察HBeAg阳性慢性乙型肝炎(CHB)患者经胸腺五肽联合恩替卡韦抗病毒治疗前后T淋巴细胞受体重排删除环(TREC)水平的变化。方法 选取2014年10月-2016年9月首都医科大学附属北京佑安医院诊治的30例HBeAg阳性CHB患者。所有患者均接受恩替卡韦和胸腺五肽治疗48周。利用real-time PCR方法检测患者外周血单个核细胞(PBMC)中TREC的水平,分析比较患者治疗前后TREC的变化;并分析TREC的水平与HBV DNA、HBeAg和HBsAg变化的相关性。计量资料2组间比较采用t检验,组内样本两个指标的相关性做Spearman相关分析。结果 联合治疗48周,24例患者获得病毒学应答,3例患者获得HBeAg阴转。治疗后TREC水平为(10.61±2.08)拷贝/103 PBMC,高于治疗前(6.03±1.71)拷贝/103 PBMC(t=9.32,P<0.0001)。病毒学应答组患者治疗后TREC水平较治疗前明显升高[(11.21±1.71)拷贝/103 PBMC vs (5.79±1.84)拷贝/103 PBMC,t=10.57,P<0.0001];病毒学未应答组患者治疗后与治疗前TREC水平差异无统计学意义[(8.21±2.08)拷贝/103 PBMC vs (7.03±0.28)拷贝/103 PBMC, t=1.38, P=0.20]。病毒学应答组和病毒学未应答组比较,治疗前PBMC中TREC水平差异无统计学意义(P>0.05),治疗后病毒学应答组PBMC中TREC水平明显高于未应答组(t=3.69, P=0.001)。患者治疗前后TREC含量与HBsAg、HBeAg水平、HBV DNA载量以及基线到48周的下降幅度均无相关性(P值均>0.05)。结论 胸腺五肽联合恩替卡韦治疗能提高HBeAg阳性CHB患者的胸腺输出功能。
【Abstract】: Objective To investigate the change in the level of T-cell receptor rearrangement excision circles (TREC) after antiviral therapy with thymopentin (TP5) and entecavir (ETV) in HBeAg-positive chronic hepatitis B (CHB) patients. Methods A total of 30 HBeAg-positive CHB patients who were diagnosed and treated in Beijing YouAn Hospital, Capital Medical University, from October 2014 to September 2016 were enrolled. All patients were given ETV combined with TP5 for 48 weeks. Real-time PCR was used to measure the level of TREC in peripheral blood mononuclear cells (PBMCs), and the change in TREC after treatment was analyzed. The correlation of TREC level with HBV DNA, HBeAg, and HBsAg was analyzed. The t-test was used for comparison of continuous data between two groups, and a Spearman correlation analysis was used to investigate the correlation between two indices. Results After the combined treatment for 48 weeks, 24 patients achieved virologic response, and 3 achieved HBeAg clearance. The level of TREC significantly increased from 6.03±1.71 copies/103 PBMCs before treatment to 10.61±2.08 copies/103 PBMCs after treatment (t=9.32, P<0.0001). The patients in the virologic response group had a significant increase in the level of TREC after treatment (11.21±1.71 copies/103 PBMCs vs 5.79±1.84 copies/103 PBMCs, t=10.57, P<0.0001), while those in the non-virologic response group had no significant change in the level of TREC after treatment (8.21±2.08 copies/103 PBMCs vs 7.03±0.28 copies/103 PBMCs, t=1.38, P=0.20). Before treatment, there was no significant difference in the level of TREC in PBMCs between the virologic response group and the non-virologic response group (P>0.05), while after treatment, the virologic response group had a significantly higher level of TREC than the non-virologic response group (t=3.69, P=0.001). A bivariate Spearman correlation analysis was performed for the levels of TREC, HBsAg, and HBeAg, HBV DNA load, and the degree of reductions from baseline to 48 weeks of treatment, and no statistical significance was found. Conclusion TP5 combined with ETV can increase thymic output function in HBeAg-positive CHB patients.
【关键字】:乙型肝炎, 慢性; 乙型肝炎e抗原; 基因重排, T淋巴细胞; 抗病毒药
【Key words】:hepatitis B, chronic; hepatitis B e antigens; gene rearrangement, T-lymphocyte; antiviral agents
【引证本文】:XIONG F, MA YP, BAO XL, et al. Change in the level of T-cell receptor rearrangement excision circles after antiviral therapy in patients with chronic hepatitis B[J]. J Clin Hepatol, 2019, 35(11): 2449-2452. (in Chinese)
熊芳, 马艳品, 鲍旭丽, 等. 慢性乙型肝炎患者抗病毒治疗后T淋巴细胞受体重排删除环水平的变化[J]. 临床肝胆病杂志, 2019, 35(11): 2449-2452.

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