局部热疗联合拉米夫定治疗慢性乙型肝炎的疗效

Zhang Lin, Shi Deng-Ping, Yang Wen-tao, Hu Bing, Weng Zhi-Ying, Xi Jian-dong, Jiang Shao-Lian, Kong Ya-mei, Li Wen-wen
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摘要

本研究旨在评价局部热疗联合拉米夫定(LAM)治疗慢性乙型肝炎(CHB)的疗效,并探讨其可能的机制。40例慢性乙型肝炎患者随机分为联合组(局部热疗+ LAM治疗;n=17)和对照组(仅用LAM治疗;n = 23)。进行肝功能、乙型肝炎病毒(HBV)标志物和HBV DNA的实验室检查。流式细胞术检测淋巴细胞亚群,包括CD3+(总T细胞)、CD4+CD8-(辅助T细胞)和CD4-CD8+(细胞毒性T细胞)。观察两种药物的副作用及耐受性。联合用药组患者的天冬氨酸转氨酶和HBV-DNA水平显著低于对照组(P< 0.05)。两组间戊型肝炎抗原/抗体转化率相近,联合治疗组CD4+/CD8+ T细胞转化率显著高于对照组(P< 0.05)。局部热疗联合LAM治疗CHB优于单独LAM,可能通过增强细胞免疫功能来实现。
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Effectiveness of Regional Hyperthermia Combined with Lamivudine in Treating Chronic Hepatitis B
The aim of this study was to evaluate the effectiveness of regional hyperthermia combined with lamivudine (LAM) for treatment of chronic hepatitis B (CHB) and explore its possible mechanism. Forty CHB patients were randomly divided into the combination group (treated with regional hyperthermia and LAM ; n=17) and control group (treated with LAM alone ; n=23). Laboratory examinations were performed for hepatic function, hepatitis B virus (HBV) markers, and HBV DNA. Lymphocyte subpopulations including CD3+ (total T cells), CD4+CD8- (helper T cells) and CD4-CD8+ (cytotoxic T cells) were detected with flow cytometry. The side effects and tolerance were observed. Aspartate aminotransferase and HBV-DNA levels were significantly lower in the combination group than in the control group (P< 0.05). Hepatitis e antigen/antibody conversion rate was similar between the two groups, whereas the combination group had significantly higher rates of CD4+/CD8+ T cells than the control group (P< 0.05). Regional hyperthermia combined with LAM is superior to LAM alone for treatment of CHB, which may be achieved by enhancing cellular immune function.
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