恩替卡韦分散片治疗对高病毒载量慢性乙肝患者的T细胞亚群及血清脂联素、IFN-γ、IL-2水平的影响

目的探讨恩替卡韦分散片(ETV)治疗对高病毒载量慢性乙肝患者的T细胞亚群及血清脂联素(ADP)、干扰素-γ(IFN-γ)、白细胞介素-2(IL-2)水平的影响。方法从本院于2018年6月至2020年6月收治慢性乙肝患者中筛选经荧光定量PCR法测定HBV-DNA>2×10⁵ IU/mL为高病毒载量86例进行研究,按随机数字表法分对照组和观察组,予以对照组常规减黄、保肝及营养支持等对症治疗,观察组在对症治疗基础上予以ETV治疗,均持续治疗6个月,比较两组T细胞亚群、病毒载量指标及Th1/Th2型与相关炎性因子水平。结果经治疗,两组CD3⁺、CD4⁺水平均见提升,CD8⁺水平有一定下降,观察组CD3⁺、CD4⁺水平较对照组更高,CD8⁺水平则更低(P<0.05);两组HBsAg、HBeAg及HBV-DNA载量水平均见相应降低,观察组低于对照组(P<0.05);两组ADP水平呈上升趋势,IFN-γ及IL-2水平均呈下降趋势,观察组ADP水平高于对照组,IFN-γ及IL-2水平均更低(P<0.05)。结论高病毒载量慢性乙肝患者应用恩替卡韦分散片治疗,有助于T细胞亚群改善,且较大程度降低了病毒载量水平,并增强了机体免疫功能。

Effect of Entecavir Dispersible Tablets Therapy on T Cell Subsets and Levels of Serum Adiponectin,IFN-γ,and IL-2 in Patients with Chronic Hepatitis B with High Viral Load

Objective To explore the effect of entecavir dispersible tablets(ETV)therapy on T cell subsets and levels of serum adiponectin(ADP),interferon-γ(IFN-γ)and interleukin-2(IL-2)in patients with chronic hepatitis B with high viral load.Methods 86 cases with high viral load determined by fluorescence quantitative PCR method of HBV-DNA>2×10⁵ IU/mL were screened for the study from the patients with chronic hepatitis B who were treated in the hospital between June 2018 and June 2020,and the enrolled subjects were divided into the control group and the observation group according to the random number table method.The control group was given symptomatic treatments such as routine biliary drainage,liver protection and nutritional support,whereas the observation group was treated with ETV on the basis of symptomatic treatments,and both continued treatment for 6 months.The T cell subsets,viral load indicators and Th1/Th2 type and related inflammatory factors were compared between the two groups.Results After treatment,the levels of CD3⁺and CD4⁺in the two groups were increased while the level of CD8⁺was decreased to a certain extent,and the levels of CD3⁺and CD4⁺in the observation group were higher than those in the control group while the level of CD8⁺was lower(P<0.05).The load levels of HBsAg,HBeAg,and HBV-DNA were correspondingly decreased in the two groups,and the load levels of the observation group were lower than those of the control group(P<0.05).The ADP level of the two groups showed an upward trend while the IFN-γand IL-2 levels showed downward trends,and the ADP level of the observation group was higher while the levels of IFN-γand IL-2 were lower compared to the control group(P<0.05).Conclusion Entecavir dispersible tablets for patients with chronic hepatitis B with high viral load can help improve the T cell subsets,reduce the viral load level to a large extent,and enhance the immune function of body.