论文部分内容阅读
目的探讨恩替卡韦片(博路定)治疗乙型肝炎肝硬化患者外周血中白细胞介素-17(IL-17)及白细胞介素13(IL-13)的变化与肝脏炎症的关系。方法选择58例乙型肝炎肝硬化患者作为实验组,选择12例正常健康体检者为对照组。采用酶联免疫吸附(ELISA)法测定口服恩替卡韦过程中血清IL-17和IL-13的含量,同时检测实验组中丙氨酸转移酶(ALT)、乙肝病毒核酸(HBV-DNA)定量和乙肝病毒标志物(HBV-M)。结果实验组ALT及HBV-DNA在第4周开始出现明显下降,HBV-DNA水平在第12周时已接近检测低限值,至第36周时已达到检测低限值(<100 IU/ml);ALT水平在第12周时已接近正常值的高限(40 IU/L),至第36周已达到正常。第48周8例患者出现HBeAg转阴,其中4例出现HBeAb转换。血清IL-17在第4周时和治疗前相比出现明显升高,其后逐渐下降,在48周时与对照组水平相似[(10.3±5.2)ng/ml vs(6.7±0.9)ng/ml];血清IL-13在第4周和12周时与治疗前相比明显下降,其后逐渐升高,在48周时与健康对照组水平相似[(180.4±31.4)ng/ml vs(190.3±28.3)ng/ml]。结论恩替卡韦在有效抑制乙肝病毒的同时,还能够有效调节IL-17和IL-13的平衡,减轻肝脏的炎症反应。
Objective To investigate the relationship between the changes of interleukin-17 (IL-17) and interleukin-13 (IL-13) in the peripheral blood of patients with hepatitis B cirrhosis and the inflammation of the liver induced by entecavir tablets. Methods Fifty-eight patients with hepatitis B cirrhosis were selected as experimental group and 12 normal healthy subjects as control group. Serum IL-17 and IL-13 levels were measured by enzyme-linked immunosorbent assay (ELISA). ALT, HBV-DNA and hepatitis B Viral marker (HBV-M). Results The levels of ALT and HBV-DNA in the experimental group decreased significantly at the 4th week. HBV-DNA levels approached the lower limit of detection at the 12th week and reached the lower limit of detection (<100 IU / ml at the 36th week) ); ALT levels approached the upper limit of normal (40 IU / L) at week 12 and reached normal at week 36. In the 48th week, 8 patients had negative HBeAg, and 4 of them had HBeAb conversion. Serum IL-17 levels increased significantly at week 4 compared with those before treatment, and then gradually decreased. The level of serum IL-17 was similar to the control group at 48 weeks [(10.3 ± 5.2) ng / ml vs (6.7 ± 0.9) ng / ml]. Serum IL-13 decreased significantly at 4 weeks and 12 weeks compared with that before treatment, and then gradually increased at 48 weeks, which was similar to that of healthy controls [(180.4 ± 31.4) ng / ml vs 190.3 ± 28.3) ng / ml]. Conclusion Entecavir can effectively inhibit the balance of IL-17 and IL-13 and relieve the inflammatory reaction in liver while inhibiting HBV effectively.