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目的研究替比夫定治疗慢性乙型肝炎(CHB)患者过程中Treg/Th17比率变化及与e抗原(HBe Ag)血清学转换的关系。方法收集2011年10月至2013年10月在沈阳医学院附属中心医院感染科应用替比夫定治疗的34例HBe Ag阳性CHB患者,在治疗前及治疗第4周、12周、24周、36周、48周,分别检测乙型肝炎标志物、肝功能、HBV DNA,Treg细胞频数、Th17细胞频数。同时选择20名健康志愿者为对照组。结果 Treg/Th17比率在第4周开始下降,至第12周达到最低值。在治疗第12周时Treg/Th17比率与HBe Ag血清学转换有显著相关性,且治疗过程中发生HBe Ag血清学转换的10例CHB患者的Treg/Th17比率与未发生HBe Ag血清学转换的24例患者的Treg/Th17比率比较差异有统计学意义。结论替比夫定治疗CHB患者过程中,Treg/Th17比率呈现动态变化,12周时Treg/Th17比率与HBe Ag血清学转换密切相关,可能成为HBe Ag血清学转换的预测指标。
Objective To study the relationship between Treg / Th17 ratio and seroconversion to e antigen (HBeAg) in telbivudine-treated patients with chronic hepatitis B (CHB). Methods Thirty-four patients with HBeAg-positive CHB treated with telbivudine in the Department of Infectious Diseases, Shenyang Medical College, Central Hospital from October 2011 to October 2013 were collected. Before and 4 weeks, 12 weeks, 24 weeks, 36 weeks, 48 weeks, respectively, detection of hepatitis B markers, liver function, HBV DNA, Treg cell frequency, Th17 cell frequency. At the same time, 20 healthy volunteers were selected as the control group. Results The Treg / Th17 ratio started to decrease from the 4th week and reached the lowest value at the 12th week. The Treg / Th17 ratio was significantly associated with HBeAg seroconversion at week 12 of treatment and the Treg / Th17 ratio in 10 CHB patients who underwent HBeAg seroconversion during the course of treatment was not significantly different from that of HBeAg seroconversion The Treg / Th17 ratio in 24 patients was significantly different. CONCLUSION: The Treg / Th17 ratio shows a dynamic change in the treatment of CHB patients with telbivudine. The Treg / Th17 ratio is closely related to the HBeAg seroconversion at 12 weeks and may be a predictor of HBeAg seroconversion.