Measurement of Th1/Th2 cytokine levels in chronic hepatitis B during telbivudine therapy
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摘要: 目的探讨慢性乙肝患者接受替比夫定抗病毒治疗后血清T淋巴细胞亚群Th1/Th2细胞因子水平的变化及与肝功能ALT恢复、HBVDNA含量变化及血清HBeAg转换的关系。方法64例HBeAg(+)慢性乙肝患者接受替比夫定抗病毒治疗,ELISA法检测治疗前及治疗24W后Th1细胞因子IL-2、IL-12及Th2细胞因子IL-4、IL-10的血清浓度变化,并同时检测肝功能ALT、HBVDNA含量的变化及HBeAg血清转换率。结果64例HBeAg(+)慢性乙肝患者接受替比夫定治疗24W后,有55例患者ALT恢复正常,占85.9%,有34例HBVDNA<5×102copies/ml,HBeAg(-),占53.1%,治疗52W,有15例发生HBeAg血清学转换,比例为23.4%。治疗组患者血清Th1细胞因子水平低于对照组,Th2细胞因子水平高于对照组,替比夫定治疗后,HBeAg阴转及血清转换患者血清Th1细胞因子浓度比治疗前升高,Th2细胞因子浓度比治疗前降低均有统计学意义(P<0.05),ALT恢复正常,HB-VDNA含量下降显著(P<0.01)。结论T细胞亚群Th1/Th2细胞因...Abstract: Objective To study the change in Th1/Th2 cytokines and its relationship with ALT, HBV DNA and HBeAg conversion in chronic hepatitis B (CHB) patients treated with telbivudine.Methods 64 HBeAg-positive CHB patients treated with telbivudine were included in the study.Th1cytokines (IL-2, IL-12) and Th2 cytokines (IL-4, IL-10) were measured by ELISA before treatment and at the 24th week after treatment.ALT and HBV DNA were evaluated at the same time.Results 86% of the patients showed normal ALT and 53% had undetectable serum HBVDNA level after 24 weeks of treatment.The HBeAg conversion rate was 23.4% at the 52nd week of treatment.The level of Th1 cytokines in the treatment group was higher and Th2 cytokines was lower than that of the control group.There was a significant difference between pre-treatment and post-treatment cytokine levels (p<0.05) .Serum HBV DNA and ALT levels were decreased dramatically with the antiviral therapy.Conclusion There is a significant correlation between serum cytokine level, ALT and HBV DNA in CHB patients treated with telbivudine.The balance between Th1/Th2 cytokines may contribute towards normal ALT, undetectable HBV DNA and HBeAg serum conversion.
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Key words:
- Telbivudine /
- chronic hepatitis B /
- cytokine
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[1]姜荣龙, 卢桥生, 骆抗先, 等.慢性乙型肝炎病毒感染者外周血T辅助细胞1、2型因子的表达[J].中华传染病杂志, 2000, 1891) ∶26-28. [2]中华医学会.慢性乙型肝炎防治指南[J].中华传染病杂志, 2005, 23 (6) ∶421-431. [3]孙永年, 黄长形.TNF-α、IL-6、IL-8、sIL-2R与乙肝病毒复制的关系[J].中国现代医学杂志, 2003, 13 (21) ∶60-62. [4]LokAS, McMahon BJ.PracticeGuidelinesCommittee, AmericanAsso-ciation for the Study ofLiverDiseases (AASLD) .Chronic hepatitis B;update of recommendations[J].Hepatology, 2004, 39∶857-861. [5]Guidotti LG, Ando K, Hobbs MV, et al.Cytotoxic T lymphocytes inhibit hepatitis B virus gene expression by a non cytotoxic mecha-nism in transgenic mice[J].Proe Natl Acad A, 2002, 99∶3764-3768. [6]Lai CL, Leung N, Teo EK, et al.A1-year trial of telbivudine, lamivudine, and the combination in patients with hepatitis B e anti-gen-positive chronic hepatitis B.Gastroenterology[J].2005, 129∶528-536. [7]蒋雪花, 孙永年, 黄祝青, 等.干扰素治疗对慢性乙肝患者细胞因子和抗病毒疗效的影响分析[J].中国现代医学杂志, 2004, 14 (24) ∶76-78. [8]何登清, 毛青.拉米夫定治疗慢性乙型肝炎患者Th1/Th2平衡的影响及意义[J].中华肝脏病杂志, 2004, 12 (8) ∶495-496.
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