拉米夫定联合干扰素α-2a治疗慢性乙型肝炎疗效分析

摘要

Objective To explore the curative effect of lamivudine combined with interferon α-2a for the treatment of hepatitis B,PD-1 and TLR-4 as testing indexes.Methods A total of 200 cases with chronic hepatitis B were randomly divided into control and experi-mental group from January 2013 to December 2014 in our hospital.Patients in the control group were only given therapy with lamivudine while patients in the experimental group were given therapy with lamivudine combined interferon α-2a.Before and 1 year after treatment ,the liver function,PD-1 level in peripheral blood and TLR-4 expression level in liver tissue were compared between the two groups .Results Two groups of patients were both abnormal in ALT before treatment ,with no statistically significant difference ( P>0.05).Three months after treat-ment,ALT in both groups was significantly decreased (P<0.05).Six months after treatment,the patients in experimental group had basic nor-mal ALT,which was statistically significantly different from the other group (P<0.05).Twelve months after treatment,patients in both groups had normal ALT,and there was no significant difference between groups (P>0.05).After treatment,PD-1 expression level of patients in both groups was significantly lower than that before treatment ,with statistically significant difference (P<0.05),and the experimental group was more obvious.Two groups of patients before treatment had both higher TLR-4 expression level in liver cell surface .The level was significantly reduced after treatment in the experimental group ( P<0.05).Conclusion Curative effect of combination therapy of lamivudine and interfer-on is improved significantly compared with the single use of lamivudine in the treatment of chronic hepatitis B .%目的：以程序性死亡分子1（PD-1）和Toll样受体-4（TLR-4）为检测指标，探讨拉米夫定联合干扰素α-2a治疗慢性乙型肝炎的疗效。方法选取200例慢性乙型肝炎患者为研究对象，随机分为对照组和试验组，每组100例。对照组给予单一拉米夫定治疗，试验组给予拉米夫定联合干扰素α-2a治疗。治疗前及治疗1年后分别检测两组患者肝功能、外周血PD-1水平以及肝脏组织中TLR-4表达水平。结果两组患者治疗前谷丙转氨酶（ALT）均表现异常，差异无统计学意义（P＞0.05）。治疗3个月后，两组ALT较治疗前显著下降（ P＜0.05）。治疗6个月后，试验组患者ALT基本正常，与对照组比较，差异有统计学意义（ P＜0.05）。治疗12个月后，两组患者ALT均正常，差异无统计学意义（P＞0.05）。两组患者治疗后，PD-1表达均比治疗前明显下降，差异有统计学意义（P＜0.05），且试验组下降更加明显。治疗前，两组患者肝脏细胞表面TLR-4表达均较高；治疗后，试验组患者肝细胞表面TLR-4表达显著减少，差异有统计学意义（P＜0.05）。结论与单一使用拉米夫相比，拉米夫定联合干扰素α-2a治疗慢性乙型肝炎疗效显著。