恩替卡韦联合阿德福韦酯治疗慢性乙肝的效果及其对血清IL-10、IFN-γ水平的影响

发布时间：2019-08-07 07:47

【摘要】：目的观察恩替卡韦联合阿德福韦酯治疗慢性乙肝的效果,并探讨其作用机制。方法选择慢性乙肝患者84例,随机分为观察组、对照组各42例。两组均常规给予保肝、对症支持治疗,对照组在此基础上口服阿德福韦酯10 mg、每日1次,观察组口服阿德福韦酯10 mg及恩替卡韦0.5 mg、每日1次。两组疗程均为6个月。观察治疗后的临床效果,比较两组治疗前后肝功能及血清IL-10、IFN-γ水平的变化,并记录两组治疗期间的不良反应。结果治疗6个月后,观察组总有效率为90.5%,对照组为73.8%,两组比较差异有统计学意义(χ2=6.273,P0.05)。治疗6个月后,观察组ALT、AST、TBIL、GGT较治疗前显著降低,且低于对照组治疗后(P均0.01)。治疗6个月后,观察组血清IL-10水平较治疗前显著降低,且低于对照组治疗后(P0.01);血清IFN-γ水平较治疗前显著升高,且高于对照组治疗后(P0.01)。治疗期间,两组不良反应症状较轻,不影响治疗。结论恩替卡韦联合阿德福韦酯治疗慢性乙肝的效果较好,能显著改善患者的肝功能;其机制可能是通过促进IL-10的分泌而减轻肝细胞局部炎症反应及通过Th1细胞分泌的IFN-γ在转录水平抑制乙肝病毒复制。
[Abstract]:Objective to observe the effect of entecavir combined with adefovir ester in the treatment of chronic hepatitis B and to explore its mechanism. Methods 84 patients with chronic hepatitis B were randomly divided into observation group (n = 42) and control group (n = 42). Both groups were given liver protection and symptomatic support therapy. On this basis, the control group was given adefovir 10 mg, once a day, while the observation group was given adefovir 10 mg and entecavir 0.5 mg, once a day. The course of treatment in both groups was 6 months. To observe the clinical effect after treatment, to compare the changes of liver function and serum IL-10,IFN- 纬 level between the two groups before and after treatment, and to record the adverse reactions of the two groups during treatment. Results after 6 months of treatment, the total effective rate was 90.5% in the observation group and 73.8% in the control group. There was significant difference between the two groups (蠂 2 鈮，

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