拉米夫定联合干扰素α―2a治疗对乙型肝炎患者PD―1及Toll―4表达影响.docVIP

拉米夫定联合干扰素α―2a治疗对乙型肝炎患者PD―1及Toll―4表达影响 　　[摘要] 目的 探讨拉米夫定联合干扰素α-2a治疗对乙型肝炎患者程序性死亡受体1（PD-1）及Toll受体4（Toll-4）表达水平的影响。 方法 选择2011年1月～2013年12月我院收治的伴有HBV-DNA、HBeAg及DNA多聚酶阳性等病毒复制标志阳性的慢性活动性乙型肝炎患者100例，将其随机分为两组，每组50例。对照组进行拉米夫定抗病毒治疗、提高机体免疫力、保证营养支持及保肝护肝等处理；观察组在对照组基础上联合应用干扰素α-2a治疗。比较治疗后两组CD8+T细胞的PD-1、Toll-4表达水平及乙型肝炎病毒DNA载量和血清丙氨酸氨基转移酶（ALT），比较治疗后两组患者临床症状发生率。 结果 观察组CD8+T细胞PD-1及Toll-4表达水平均显著低于对照组（P0.05）；观察组患者血清乙型肝炎病毒DNA载量及血清ALT均显著低于对照组（P0.05）；观察组患者厌食、乏力、恶心呕吐及肝区隐痛的发生率显著低于对照组（P0.05）。 结论 干扰素α-2a能显著降低CD8+T细胞PD-1及Toll-4的表达水平，提高机体免疫力，降低乙型肝炎病毒DNA水平，改善患者肝功能。 　　[关键词] 干扰素α-2a；乙型肝炎；程序性死亡受体1；Toll受体4 　　[中图分类号] R512.6+2 [文献标识码] A [文章编号] 1674-4721（2016）05（b）-0112-04 　　[Abstract] Objective To investigate the effect of programmed death receptor 1（PD-1） and Toll receptor 4（Toll-4） expression in lamivudine combined with interferon α-2a treating hepatitis B patients. Methods 100 cases with chronic active hepatitis B from January 2011 to December 2013 in our hospital were randomly divided into two groups，each group 50 cases，the control group were used lamivudine anti-virus，improving immunity，nutritional support and ensuring hepatoprotective，the observation group were combined with interferon α-2a based on the control group，then the PD-1 and Toll-4 level of CD8+ T cell，and HBV DNA loading and serum ALT，the present rate of clinical symptoms were compared. Results The PD-1 and Toll-4 level of CD8+T cell in the observation group was lower than that in control group respectively（P0.05），HBV DNA loading and serum ALT in the observation group was lower than that in control group respectively（P0.05），the present rate of anorexia，fatigue，nausea，vomiting and liver pain in the observation group was lower than that in control group respectively（P0.05）. Conclusion Interferon α-2a can significantly decreased the PD-1 and Toll-4 level of CD8+T cell，improved immunity，reduced HBV DNA levels，so it can improve liver function. 　　[Key words] Interferon α-2a；Hepatitis B；Programmed death 1；Toll receptor 4 　　我国是慢性乙型肝炎的高发国家，统计学