拉米夫定联合抗乙肝胎盘转移因子对慢乙肝疗效及免疫功能影响.doc

拉米夫定联合抗乙肝胎盘转移因子对慢乙肝疗效及免疫功能影响 　　作者：黎琮毅,涂燕云,方健强,邱 琦 　　作者单位：广西壮族自治区江滨医院消化内科(黎琮毅 方健强 邱 琦) , 广西中医学院附属瑞康医院肝胆内科(涂燕云) 　　【摘要】 目的 观察拉米夫定联合抗乙肝胎盘转移因子治疗慢性乙型病毒性肝炎的疗效及对免疫功能的影响。方法 将60例慢乙肝患者随机分为治疗组和对照组，各30例,两组均予拉米夫定100mg每日早晨空腹顿服1年,治疗组加用抗乙肝胎盘转移因子4ml肌肉注射,疗程6个月。检测治疗前及治疗后3个月、6个月、1年后两组患者的ALT水平及HBeAg、HBVDNA、T淋巴细胞亚群。结果 治疗3个月、6个月、1年后,治疗组的HBVDNA阴转率和ALT复常率均显著高于对照组(P0.05),外周血CD4亚群水平上调，CD4/CD8比值趋于正常,与对照组相比差异有统计学意义(P0.05)。治疗1年后，治疗组HBVYMDD变异的发生率低于对照组。结论 拉米夫定和抗乙肝胎盘转移因子联合治疗慢性乙型肝炎疗效显著,提高了机体的免疫能力，且疗效持久。 　　【关键词】 慢性乙型肝炎，T淋巴细胞亚群，拉米夫定，抗乙肝胎盘转移因子 　　【Abstract】 Objective To observe the effect of combined application of Lamivudine and anti-HBV placenta transfer factor in treating patients with chronic hepatitis B and its influence on immunity. Methods 60 patients were enrolled and randomized into two groups：The treated group (30 cases) and the control group (30 cases). Both groups received Lamivudine 100mg daily for 12 month and treat group combined with anti-HBV placenta transfer factor 4mg daily for 6 month. Both groups were received 3 month and 6 month and 12 month treatment. ALT, HBeAg, HBVDNA,T-cell subset were evaluated. Results After 3 month and 6 month and 12 month treatment,the negative rate of serumHBVDNA and ALT normalization rate in treated group were than in control group(P0.05).CD4 T-cell leves increased and CD4/CD8 became normal in treated group，and there significant difference between treat and control groups(P0.05). the differentiation rate of HBVYMDD in treated group were than in control group after 12 month. Conclusions Lamivudine and anti-HBV placenta transfer factor combination can significantly treat patients with chronic hepatitis B and enhance body immune level for a long time. 　　【Key words】 Chronic Hepatitis B T-cell subset Lamivudine Anti-HBV placenta transfer factor 慢性乙型肝炎(以下简称慢乙肝)是指人感染乙型肝炎病毒(HBV)后，病毒持续6个月仍未被清除的常见传染病。慢乙肝的发病机制目前公认与乙型肝炎病毒感染有直接关系,多数学者还认为与机体调节功能低下、感染乙肝后出现免疫调节功能紊乱,导致肝损害有关[1]。目前广为应用的抗病毒药拉米夫定是我国和全球被批准用于治疗慢性乙型肝炎的第1种口服药，其作用靶位是抑制乙型肝炎病毒基因组(HBVDNA)聚合酶的活性;抗乙肝胎盘转