恩替卡韦联合苦参素治疗慢性乙型肝炎患者疗效及其对外周血辅助性T淋巴细胞的影响*

doi:10.3969/j.issn.1672-5069.2020.01.008

摘要/Abstract

摘要： 目的探讨恩替卡韦联合苦参素治疗慢性乙型肝炎(CHB)患者疗效及其对外周血淋巴细胞百分比的影响。方法随机将180例CHB 患者分为对照组90例和观察组90例。两组患者均接受恩替卡韦治疗,观察组患者在此基础上加用苦参素口服,观察6个月。采用ELISA 法检测血清基质金属蛋白酶-9(MMP-9)和转化生长因子-β1(TGF-β1),采用RIA 法测定血清血管紧张素II(Ang-II)水平,使用流式细胞仪检测外周血辅助性T细胞及CD80 和CD86 阳性细胞百分比。结果在治疗6个月末,观察组血清ALT 复常、HBeAg 和HBV DNA 阴转率分别为34.4%、91.1% 和86.7%,显著高于对照组的18.9%、78.9%和63.3%(P<0.05);血清MMP-9、TGF-β1 和Ang-II 水平分别为(30.5±3.6)ng/ml 、(19.5±2.2) ng/ml 和(33.7±4.1)ng/dL,与对照组【(22.4±2.7)ng/ml 、(22.6±2.8) ng/ml 和(46.3±4.9)ng/dL,P<0.05】比,差异显著;Th2和Th1细胞及CD80和CD86阳性细胞百分比分别为(6.6±1.5)%、(9.8±2.3)%、(2.5±0.7)%和(1.6±0.5)%,与对照组【(9.0±2.7)%、(7.9±1.4)%、(1.9±0.3)%和(1.1±0.2)%,P<0.05】比,差异显著。结论应用恩替卡韦联合苦参素治疗CHB患者可能通过改善机体的免疫功能而提高近期疗效。

关键词: 慢性乙型肝炎, 恩替卡韦, 苦参素, 治疗

Abstract: Objective The aim of this study was to investigate the efficacy of entecavir and matrine combination therapy in patients with chronic hepatitis B (CHB). Methods 180 patients with CHB were enrolled in our hospital, and were randomly divided into control (n=90) and observation (n=90) group. All patients received entecavir, and those in the observation group received matrine and entecavir combination. Serum matrix metalloproteinase-9 (MMP-9), transforming growth factor-β1 (TGF- β1) and angiotensin-II (Ang-II) were detected. The percentages of peripheral blood T lymphocytes as well as CD80 and CD86 positive cells were determined by FCM. Results At the end of six-month observation, serum rates of ALT normalization, serum HBeAg negativity and HBV DNA loss in the observation group were 34.4%, 91.1% and 86.7%, significantly higher than 18.9%, 78.9% and 63. 3%(P<0.05) in the control; serum MMP-9, TGF-β1 and Ang-II levels were (30.5±3.6)ng/ml , (19.5±2.2) ng/ml and (33.7±4.1)ng/dL, significantly different as compared to [(22.4±2.7)ng/ml , (22.6±2.8) ng/ml and (46.3±4.9)ng/dL, P<0.05] in the control; the percentages of Th2 and Th1 cells as well as CD80 and CD86 positive cells were (6.6±1.5)%, (9.8±2.3)%, (2.5±0.7)% and (1.6±0.5)%, significantly different as compared to 【(9.0±2.7)%, (7.9±1.4)%, (1.9±0.3)% and (1.1±0.2)%,P<0.05】 in the control group. Conclusion The combination therapy of matrine and entecavir improve the short-term efficacy in patients with CHB, which might be related to the regulation of imbalanced immune response and inhibition of liver fibrosis.

Key words: Hepatitis B, Entecavir, Matrine, Therapy

李永华, 孙延芬, 王佳佳, 李艳颖, 于收. 恩替卡韦联合苦参素治疗慢性乙型肝炎患者疗效及其对外周血辅助性T淋巴细胞的影响^*[J]. 实用肝脏病杂志, 2020, 23(1): 22-25.

Li Yonghua, Sun Yanfen, Wang Jiajia, et al. Efficacy of entecavir and matrine combination therapy in patients with chronic hepatitis B[J]. Journal of Practical Hepatology, 2020, 23(1): 22-25.

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恩替卡韦联合苦参素治疗慢性乙型肝炎患者疗效及其对外周血辅助性T淋巴细胞的影响^*

Efficacy of entecavir and matrine combination therapy in patients with chronic hepatitis B

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