关键词: 慢性乙型肝炎, 聚乙二醇干扰素α, -2b, T淋巴细胞亚群, 细胞因子

Abstract: Objective To investigate the effect of pegylated interferon α-2b on peripheral blood T lymphocyte subsets and serum cytokine levels in patients with chronic hepatitis B. Methods 184 patients with chronic hepatitis B were recruited in our hospital between January 2014 and January 2016,and 92 patients were treated with combination of pegylated interferon α-2b and entecavir for 48 weeks,and 92 cases were with entecavir alone. The liver function indexes,serum cytokines IL-6,INF-α,IL-17,IL-4 and TGF-β1,peripheral blood T lymphocyte subsets and nuclear transcription factor （Foxp3,RORγt,IL-17） mRNA were evaluated in all patients before and after treatment. Results At the end of 24 w follow-up after discontinuation of the regimen,serum HBV DNA negative rate in the combined group and entecavir group were 86.96% and 84.78%,respectively（P>0.05）,and serum HBeAg negative rate in combined group was 28.89%（13/45）,without significant difference as compared with that in entecavir group [15.22%（7/46）,P>0.05];there were no significant differences before treatment between the two groups （P>0.05） as respect to serum TBIL,ALT,ALB levels and PTA,while serum ALT level in the combination group at the time of follow-up was （34.6±11.6） U/L,significantly lower than （64.6±20.5） U/L（P<0.05） in the entecavir group; before treatment,the percentage of CD3+,CD8+,CD4+ cells and the ratio of CD4+/CD8+ had no significant difference between the two groups （P>0.05）,while after treatment,the percentage of CD3+,CD4+ cells and the ratio of CD4+/CD8+ in peripheral blood in combination group were （75.6±14.5）%,（42.7±10.3）% and （1.4±0.6）,significantly higher than those in the entecavir group[（66.8±14.4）%,（436.7±8.5）% and（1.0±0.5）,P<0.05];the percentage of CD8+ cells was （29.3±7.3） %,significantly lower than that in the entecavir Group [（34.8±8.5）%,P<0.05];there was no significant difference between the two groups（P>0.05） as respect to the percentage of NK cells;before treatment,serum levels of IL-6,IL-17,IL-4,INF-ɑ and TGF-β1 showed no significant differences between the two groups（P>0.05）,while after the treatment,serum level of IL-6 in the combination group was（6.8±1.2） pg/ml,significantly higher than that in the entecavir group[（3.5±0.8） pg/ml,P<0.05];serum IL-17 level was （0.7±0.3） pg/ml,significantly lower than that in the entecavir group [（2.8±0.9） pg/ml,P<0.05];serum IL-4 level was（1.4±0.5） pg/ml,significantly lower than that in the entecavir group[（3.8±1.5） pg/ml,P<0.05];serum level of INF-ɑ in the combination group was（4.0±1.3） pg/ml,significantly higher than that in the entecavir group [（2.6±0.9） pg/ml,P<0.05];there was no significant difference between the two groups （P>0.05） as respect to serum level of TGF-β1;serum levels of RORγt,Foxp3 and IL-17mRNA before treatment were not significantly different between the two groups （P>0.05）,while serum level of RORγt in the combination group after treatment was （0.86±0.31）,significantly lower than that in the entecavir group [（1.56±0.43）,P<0.05],and there were no significant differences between the two groups（P>0.05） as respect to serum Foxp3 and IL-17 mRNA levels. Conclusion Pegylated interferon α-2b can effectively improve the immune functions of patients with chronic hepatitis B by regulating transcription and expression of cytokines from various aspects,which has good clinical implication for patients with chronic hepatitis B.

Key words: Hepatitis B, Pegylated interferon α-2b;, CD4+T lymphocytes, Cytokines