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目的观察干扰素α治疗慢性乙型肝炎患儿T淋巴细胞亚群的变化。方法将49例慢性乙型肝炎患儿随机分为治疗组(29例)和对照组(20例)。2组均采用保肝治疗,治疗组加用重组人干扰素α-2 b,按体表面积(500万U.m-2)计算给药,隔日1次,疗程24周。观察2组治疗后肝功能HBV DNA、HBsAg、HBeAg水平及T淋巴细胞亚群的变化。结果与治疗前比较,治疗组治疗24周ALT、AST、HBeAg及HBVDNA水平均明显下降,差异均有统计学意义(Pa<0.01);对照组治疗24周与治疗前比较ALT及AST也有所下降,差异均有统计学意义(Pa<0.01)。治疗24周,治疗组与对照组比较,ALT、AST、HBeAg及HBVDNA水平下降,差异均有统计学意义(Pa<0.01)。治疗24周治疗组CD4+、CD8+及CD4+/CD8+升高,与治疗前比较差异均有统计学意义(Pa<0.05,0.01),与对照组比较差异亦均有统计学意义(Pa<0.05,0.01)。治疗24周,治疗组HBV DNA阴转率为51.7%(15/29例),HBeAg血清转换率为34.5%(10/29例),与对照组比较差异均有统计学意义(P<0.01,0.05)。结论干扰素α可使慢性乙型肝炎患儿CD4+、CD8+水平增加且CD4+/CD8+升高,可有效抑制慢性重型乙型肝炎患儿HBVDNA复制,明显改善肝功能。
Objective To observe the changes of T lymphocyte subsets in children with chronic hepatitis B treated with interferon α. Methods 49 children with chronic hepatitis B were randomly divided into treatment group (n = 29) and control group (n = 20). Both groups were treated with Hepatitis B treatment. The treatment group was treated with recombinant human interferon alpha-2b, and the dosage was calculated according to the body surface area (5 million U.m-2). The treatment was given every other day for 24 weeks. The changes of liver function HBV DNA, HBsAg and HBeAg levels and T lymphocyte subsets in the two groups were observed. Results Compared with those before treatment, the levels of ALT, AST, HBeAg and HBVDNA in the treatment group decreased significantly at 24 weeks of treatment (P <0.01), and the levels of ALT and AST in the control group decreased 24 weeks after treatment , The differences were statistically significant (Pa <0.01). After treatment for 24 weeks, the levels of ALT, AST, HBeAg and HBVDNA in treatment group and control group decreased significantly (Pa <0.01). The levels of CD4 +, CD8 + and CD4 + / CD8 + in the treatment group after 24 weeks treatment were significantly higher than those before treatment (Pa <0.05,0.01), and there were also significant differences compared with the control group (Pa <0.05,0.01 ). After 24 weeks treatment, the negative rate of HBV DNA in the treatment group was 51.7% (15/29) and the HBeAg seroconvertion rate was 34.5% (10/29) in the treatment group, with significant difference compared with the control group (P <0.01, 0.05). Conclusions Interferon α can increase the level of CD4 +, CD8 + and CD4 + / CD8 + in children with chronic hepatitis B, and can effectively inhibit HBVDNA replication and improve liver function in children with chronic severe hepatitis B.