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中国临床药理学与治疗学 ›› 2011, Vol. 16 ›› Issue (6): 661-665.

• 药物治疗学 • 上一篇    下一篇

恩替卡韦与阿德福韦酯抑制乙型肝炎调节性T细胞的效价差异

邹明智   

  1. 廉江市人民医院药剂科,廉江 524400,广东
  • 收稿日期:2011-01-27 修回日期:2011-03-04 发布日期:2011-07-25
  • 作者简介:邹明智,男,本科,副主任药师,研究方向:临床药学。 Tel: 13822518966 E-mail: smartzou@126.com

Comparison of entecavir and adefovir dipivoxil on suppressing for the function of regulatory T cells for patients with chronic hepatitis B

ZOU Ming-zhi   

  1. Department of Pharmacy, People's Hospital of Lianjiang,Lianjiang 524400, Guangdong, China
  • Received:2011-01-27 Revised:2011-03-04 Published:2011-07-25

摘要: 目的: 比较恩替卡韦(ETV)与阿德福韦酯(ADV)在抑制慢性乙型肝炎(CHB)患者调节性T细胞(Treg)效价的差异。方法: 收集36例CHB患者随机分为ETV及ADV组,分别给予口服ETV 0.5 mg q.d.及ADV 10 mg q.d.;治疗48周,分别于第12、24、36及48周采血检测Treg的含量,使用定量PCR检测其功能因子叉头蛋白p3(Foxp3)mRNA含量,用ELISA检测其细胞因子白介素10(IL-10)及转化生长因子β1(TGF-β1)的含量,并检测乙肝病毒定量(HBV DNA)、肝功能。结果: 治疗前两组患者上述指标均不存在统计学差异(P>0.05);治疗后第24、36及48周ETV组Treg含量均显著低于ADV组(P<0.05);ETV组第12、36及48周的Foxp3均低于ADV组;ETV组第48周的IL-10含量低于ADV;ETV组第36及48周的TGF-β1含量低于ADV组(P<0.05);ETV组第12及36周的HBV DNA低于ADV组,且第48周两组的HBV DNA均已降至1000 copies/mL的参考值以内;第12周ETV组的ALT显著低于ADV组,ETV组其余时间点的ALT以及总胆红素均与ADV组不存在统计学差异;相关性分析显示Treg与HBV DNA呈显著正相关性(r=0.785,P=0.016)。结论: 在抗HBV效价相当的情况下,ETV抑制调节性T细胞的效价优于ADV。

关键词: 乙型肝炎, 恩替卡韦, 阿德福韦酯, 调节性T细胞, 细胞因子

Abstract: AIM: To observe the effect of entecavir (ETV) and adefovir dipivoxil (ADV)on suppressing for the function of regulatory T cells (Treg) for patients with chronic hepatitis B(CHB). METHODS: Thirty six CHB patients were randomly divided into the ETV and ADV groups. Patients in ETV group were administrated ETV 0.5 mg q.d., whereas the ones in the ADV group were dosed with ADV 10 mg q.d.. All the subjects were treated for 48 weeks and were followed at the end of the 12th, 24th, 36th and 48th week to collect the peripheral blood for test. Flow cytometry was applied to test the percentage of Treg, whose cytokines including IL-10 and TGF-β1 were detected by ELISA. Real time PCR was used to test the quantities of HBV DNA as well as the Foxp3 mRNA. Besides, the liver function including ALT and T-Bil were also examined for all the CHB patients. RESULTS: There was no statistical difference between the two groups before therapy. The percentages of Treg in ETV group were significantly lower than those of ADV group at the end of the 24th, 36th and 48th week. The levels of Treg's functional factors, the Foxp3, IL-10 and TGF-β1, were also totally lower in the ETV group when compared with the ADV group (P<0.05). For the function of anti-HBV, the HBV DNA copies in ETV group were significantly lower than those in ADV group at the end of the 12th and 36th week (P<0.05). The level of ALT was also significantly lower in ETV group at the end of the 12th week when compared with the ADV group (P<0.05). But there was no statistical difference of T-Bil level between any point times of follow-up. Pearson analysis showed that percentages of Treg correlated the copies of HBV-DNA positively(r=0.785 and P=0.016). CONCLUSION: Entecavir is proven to be more effective on suppressing for the function of regulatory T cells for patients with CHB when compared with adefovir dipivoxil.

Key words: Hepatitis B, Entecavir, Adefovir dipivoxil, Regulatory T cells, Cytokines

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