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胸腺肽α1对乙型肝炎肝硬化失代偿期患者淋巴细胞亚群的影响
Effect of thymosin α1 on lymphocyte subsets in patients with decompensated hepatitis B cirrhosis
文章发布日期:2017年10月11日  来源:  作者:仝静,孙长宇,杨黎冰,等  点击次数:147次  下载次数:22次

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【摘要】:目的观察乙型肝炎肝硬化失代偿期患者应用胸腺肽α1后外周血淋巴细胞亚群的变化,分析胸腺肽α1对患者免疫功能的影响。 方法选取2015年10月-2016年12月郑州大学第一附属医院收治的乙型肝炎肝硬化失代偿期患者106例,随机分为对照组和治疗组各53例,另选同期20例体检者作为健康组。对照组给予内科综合治疗,治疗组在综合治疗的基础上加用胸腺肽α1,分别于治疗前、治疗12周后使用流式细胞仪器检测患者外周血CD3+、CD4+、CD8+细胞数、CD4+/CD8+比值、CD19百分比、NK细胞百分比。观察临床症状和并发症,以及不良反应发生情况。计量资料多组间比较采用方差分析,进一步两两比较采用LSD-t检验;两组间比较采用成组t检验或配对t检验。计数资料的组间比较采用χ2检验。结果治疗前,与健康组相比,治疗组和对照组患者外周血CD3+、CD4+、CD8+细胞数、CD4+/CD8+比值、CD19百分比、NK细胞百分比均明显降低(P值均<0.05);治疗12周后,与对照组相比,治疗组CD3+、CD4+、CD8+细胞数明显升高(t值分别为5.051、5.379、2.066,P值均<0.05),CD4+/CD8+比值、CD19细胞百分比、NK细胞百分比有升高趋势(P值均>0.05)。治疗组治疗12周与治疗前相比,CD3+细胞数、CD4+细胞数、CD4+/CD8+比值明显升高(t值分别为7647、7851、4384,P值均<0001)。治疗过程中,出现的不良反应为头晕、头痛,对照组和治疗组患者不良反应发生率比较,差异无统计学意义(χ2=1039,Ρ=0308)。所有病例未发生严重不良反应。结论胸腺肽α1可明显改善乙型肝炎肝硬化失代偿患者淋巴细胞亚群比例失衡问题,提高患者免疫功能。
【Abstract】:ObjectiveTo investigate the change in peripheral blood lymphocyte subsets after the application of thymosin α1 in patients with decompensated hepatitis B cirrhosis, as well as the effect of thymosin α1 on immune function. MethodsA total of 106 patients with decompensated hepatitis B cirrhosis who were admitted to The First Affiliated Hospital of Zhengzhou University from October 2015 to December 2016 were enrolled and randomly divided into control group and treatment group, with 53 patients in each group, and 20 healthy subjects who underwent physical examination were enrolled as healthy group. The patients in the control group were given comprehensive medical treatment, and those in the treatment group were given thymosin α1 in addition to the comprehensive medical treatment. Flow cytometry was used to measure peripheral blood CD3+, CD4+, and CD8+ cells, CD4+/CD8+ ratio, and percentages of CD19 cells and natural killer (NK) cells before treatment and after 12 weeks of treatment. Clinical symptoms, complications, and adverse events were observed. An analysis of variance was used for comparison of continuous data between multiple groups, and the least significant difference t-test was used for further comparison between any two groups; the independent-samples t test or paired t-test was used for comparison between two groups. The chi-square test was used for comparison of categorical data between groups. ResultsBefore treatment, the treatment group and the control group had significantly lower numbers of peripheral blood CD3+, CD4+, and CD8+ cells, CD4+/CD8+ ratio, and percentages of CD19 cells and NK cells than the healthy group (all P<0.05). After 12 weeks of treatment, the treatment group showed significant increases in the numbers of CD3+ and CD4+ cells and CD4+/CD8+ ratio(t=7.647,7851, and 4384, all P<0001); compared with the control group, the treatment group had significantly increased numbers of CD3+, CD4+, and CD8+ cells (t=5.051, 5.379, and 2.066, all P<005) and slightly increaseed CD4+/CD8+ ratio and percentages of CD19 cells and NK cells (all P>0.05). The adverse events during treatment included dizziness and headache, and there was no significant difference in the incidence rate of adverse events between the control group and the treatment group (χ2=1039,P=0308). No patient experienced serious adverse events. ConclusionIn patients with decompensated hepatitis B cirrhosis, thymosin α1 can significantly improve the imbalance of lymphocyte subsets and enhance their immune function.
【关键字】:肝硬化; 肝炎, 乙型; 淋巴细胞亚群; 胸腺素
【Key words】:liver cirrhosis; hepatitis B; lymphocyte subsets; thymosin
【引证本文】:仝静, 孙长宇, 杨黎冰, 等. 胸腺肽α1对乙型肝炎肝硬化失代偿期患者淋巴细胞亚群的影响[J]. 临床肝胆病杂志, 2017, 33(11): 2132-2135.

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