ADV联合多烯磷脂酰胆碱治疗CHB及对细胞因子影响

ADV联合多烯磷脂酰胆碱治疗CHB及对细胞因子影响

高翔,张帆,兰昱,王娜,刘盈,沈秉正

武汉大学人民医院中心实验室,武汉大学人民医院药学部,武汉大学人民医院药学部,武汉大学人民医院药学部,武汉大学人民医院药学部,武汉大学人民医院药学部

收稿日期:2017-08-23 修回日期:2017-08-23 出版日期:2017-10-25
基金资助:
湖北省自然科学基金青年项目（项目编号：2015CFB350；项目名称：过氧化氢介导的信号通路在调控植物发育和抗病中的作用和机制研究）；病毒学国家重点实验室开放研究基金资助项目(项目编号：2016KF002；项目名称：新型蝎毒素多肽Ctri2123抗HCV研究)

Effects of Adefovir Dipivoxil Combined with Polyene Phosphatidylcholine on Serum Cytokines in Patients with Chronic Hepatitis B

Gao Xiang,Zhang Fan,Lan Yu,Wang Na,Liu Ying and Shen Bingzheng

Renmin Hospital of Wuhan University,Renmin Hospital of Wuhan University,Renmin Hospital of Wuhan University,XXX,Renmin Hospital of Wuhan University,Renmin Hospital of Wuhan University

Received:2017-08-23 Revised:2017-08-23 Online:2017-10-25

摘要/Abstract

摘要： 目的：研究慢性乙型肝炎（CHB）患者使用阿德福韦酯（ADV）联合多烯磷脂酰胆碱药物治疗后4种血清细胞因子白细胞介素-6（IL-6）、白细胞介素-10（IL-10）、白细胞介素-21（IL-21）和肿瘤坏死因子（TNF-α）水平的变化。方法：筛选我院就诊且符合纳入标准的CHB患者48例，其中20例单用ADV进行抗乙肝病毒治疗， 28例使用ADV联合多烯磷脂酰胆碱进行治疗。分别在单用或联用药物进行抗病毒药物治疗前后检测HBV-DNA载量、HBeAg转阴率及血清中细胞因子IL-6、IL-10、IL-21和TNF-α的含量。结果：与单用抗乙肝病毒药ADV相比，与多烯磷脂酰胆碱联合使用能更好地降低HBV-DNA载量、提高乙型肝炎E抗原（HBeAg）转阴率，降低IL-6（P=1.08×10-3）和TNF-α（P=4.1×10-2）因子水平，同时升高IL-10（P=1.88×10-5）和IL-21（P=3.5×10-2）水平，能更好改善患者肝脏功能，差异有统计学意义。结论：将抗乙肝病毒药ADV与保肝护肝药多烯磷脂酰胆碱合用能取得更好的治疗效果，提高患者生活质量。

Abstract: Objective：To explore the the serum cytokine level of IL-6，IL-10，IL-21 and TNF-α in chronic hepatitis B（CHB） patients before and after the treatment of adefovir dipivoxil（ADV） combined with polyene phosphatidylcholine.Methods：48 patients with CHB who came to our hospital were selected according to the inclusion criteria. Of them，20 patients were treated with ADV，and the other 28 patients were treated with ADV combined with polyene phosphatidylcholine.HBV-DNA loads， HBeAg seroconversion rates and the level of serum cytokine IL-6，IL-10，IL-21 and TNF-α were detected before and after the treatment of medications.Results：Compared to the treatment of ADV alone，combing ADV with polyene phosphatidylcholine decreased HBV-DNA loads， increased the overcast rates of HBeAg，and displayed stronger ability to reduce the level of IL-6 (P=1.08×10-3) and TNF-α (P=4.1×10-2)，enhanced the level of IL-10 (P=1.88×10-5) and IL-21 (P=3.5×10-2)，and improved liver function. The differences were statistically significant.Conclusion： Combination therapy with ADV plus polyene phosphatidylcholine greatly improved liver function and quality of life.

高翔,张帆,兰昱,王娜,刘盈,沈秉正. ADV联合多烯磷脂酰胆碱治疗CHB及对细胞因子影响[J]. .

Gao Xiang,Zhang Fan,Lan Yu,Wang Na,Liu Ying and Shen Bingzheng. Effects of Adefovir Dipivoxil Combined with Polyene Phosphatidylcholine on Serum Cytokines in Patients with Chronic Hepatitis B[J]. .

参考文献

[1] Lu FM, Zhuang H. Management of hepatitis B in China [J]. 中华医学杂志(英文版), 2009, 122(1):3-4.
[2] 中华医学会肝病学分会. 慢性乙型肝炎防治指南(2015年版) [J]. 实用肝脏病杂志, 2016, 19(3):1-19.
[3] 崔玲, 王丽, 张玉林. 多烯磷脂酰胆碱联合阿德福韦酯对拉米夫定耐药乙型肝炎的疗效[J]. 西北药学杂志, 2016, 31(5):511-513.
[4] 中华医学会肝病学分会,中华医学会感染病学分会.慢性乙型肝炎防治指南(2010年版)[J].中华肝脏病杂志,2011,19(1):13-24.
[5] Knolle P A, L?ser E, Protzer U, et al. Regulation of endotoxin-induced IL-6 production in liver sinusoidal endothelial cells and Kupffer cells by IL-10 [J]. Clin Exp Immunol,1997, 107(3):555–561.
[6] Smith W L, Dewitt D L, Garavito R M. Cyclooxygenases: structural, cellular, and molecular biology [J]. Annu Rev Biochem, 2003, 69(69):145.
[7] Tanabe T, Tohnai N. Cyclooxygenase isozymes and their gene structures and expression [J]. Prostaglandins Other Lipid Mediat, 2002, 68-69(1-4):95-114.
[8] Gao L, Chen X, Zhang L, et al. Association of IL-10 polymorphisms with hepatitis B virus infection and outcome in Han population[J]. Eur J Med Res, 2016, 21(1):1-6.
[9] 李晨, 邢少军, 段学章,等. 乙型肝炎肝硬化患者外周血调节性T细胞频率及血清IL-1β、IL-6和IL-10水平的变化[J]. 实用肝脏病杂志, 2012, 15(3):244-246.
[10] 石文波, 盛慧萍, 杨岩,等. 阿德福韦酯对慢性乙型肝炎患者血清IFN-γ、IL-10、乙型肝炎病毒DNA水平及肝组织病理的影响[J]. 西安交通大学学报医学版, 2014, 35(1):77-80.
[11] 丁茸, 马世武. 白细胞介素21在慢性乙型肝炎病毒感染中作用的研究进展[J]. 中华肝脏病杂志, 2016, 24(6):469-473.
[12] Morita R, Schmitt N, Bentebibel S E, et al. Human Blood CXCR5₊CD4₊ T Cells Are Counterparts of T Follicular Cells and Contain Specific Subsets that Differentially Support Antibody Secretion[J]. Immunity, 2011, 34(1):108-121.
[13] 许茵, 华忠, 俞萍, 等. 阿德福韦酯治疗慢性乙肝后细胞免疫水平的临床研究[J]. 中国现代医学杂志, 2016, 26(21): 94-96.
[14] Yong K P, Park E S, Kim D H, et al. Cleaved c-FLIP mediates the antiviral effect of TNF-α against hepatitis B virus by dysregulating hepatocyte nuclear factors[J]. J Hepatol, 2015, 64(2):268-277.
[15] 刘守春,侯绪娜.多烯磷脂酰胆碱治疗慢性乙型肝炎48例临床分析[J].中国实用医药, 2009, 4(3):179-180.
[16] 王涛, 陈东风. 多烯磷脂酰胆碱通过过氧化物酶体增殖物激活爱体α/肉碱棕榈酰基转移酶1A通路影响肝细胞脂肪变性[J]. 中华肝脏病杂志, 2016, 24(4):291-296.[1] Lu FM, Zhuang H. Management of hepatitis B in China [J]. 中华医学杂志(英文版), 2009, 122(1):3-4.
[2] 中华医学会肝病学分会. 慢性乙型肝炎防治指南(2015年版) [J]. 实用肝脏病杂志, 2016, 19(3):1-19.
[3] 崔玲, 王丽, 张玉林. 多烯磷脂酰胆碱联合阿德福韦酯对拉米夫定耐药乙型肝炎的疗效[J]. 西北药学杂志, 2016, 31(5):511-513.
[4] 中华医学会肝病学分会,中华医学会感染病学分会.慢性乙型肝炎防治指南(2010年版)[J].中华肝脏病杂志,2011,19(1):13-24.
[5] Knolle P A, L?ser E, Protzer U, et al. Regulation of endotoxin-induced IL-6 production in liver sinusoidal endothelial cells and Kupffer cells by IL-10 [J]. Clin Exp Immunol,1997, 107(3):555–561.
[6] Smith W L, Dewitt D L, Garavito R M. Cyclooxygenases: structural, cellular, and molecular biology [J]. Annu Rev Biochem, 2003, 69(69):145.
[7] Tanabe T, Tohnai N. Cyclooxygenase isozymes and their gene structures and expression [J]. Prostaglandins Other Lipid Mediat, 2002, 68-69(1-4):95-114.
[8] Gao L, Chen X, Zhang L, et al. Association of IL-10 polymorphisms with hepatitis B virus infection and outcome in Han population[J]. Eur J Med Res, 2016, 21(1):1-6.
[9] 李晨, 邢少军, 段学章,等. 乙型肝炎肝硬化患者外周血调节性T细胞频率及血清IL-1β、IL-6和IL-10水平的变化[J]. 实用肝脏病杂志, 2012, 15(3):244-246.
[10] 石文波, 盛慧萍, 杨岩,等. 阿德福韦酯对慢性乙型肝炎患者血清IFN-γ、IL-10、乙型肝炎病毒DNA水平及肝组织病理的影响[J]. 西安交通大学学报医学版, 2014, 35(1):77-80.
[11] 丁茸, 马世武. 白细胞介素21在慢性乙型肝炎病毒感染中作用的研究进展[J]. 中华肝脏病杂志, 2016, 24(6):469-473.
[12] Morita R, Schmitt N, Bentebibel S E, et al. Human Blood CXCR5₊CD4₊ T Cells Are Counterparts of T Follicular Cells and Contain Specific Subsets that Differentially Support Antibody Secretion[J]. Immunity, 2011, 34(1):108-121.
[13] 许茵, 华忠, 俞萍, 等. 阿德福韦酯治疗慢性乙肝后细胞免疫水平的临床研究[J]. 中国现代医学杂志, 2016, 26(21): 94-96.
[14] Yong K P, Park E S, Kim D H, et al. Cleaved c-FLIP mediates the antiviral effect of TNF-α against hepatitis B virus by dysregulating hepatocyte nuclear factors[J]. J Hepatol, 2015, 64(2):268-277.
[15] 刘守春,侯绪娜.多烯磷脂酰胆碱治疗慢性乙型肝炎48例临床分析[J].中国实用医药, 2009, 4(3):179-180.
[16] 王涛, 陈东风. 多烯磷脂酰胆碱通过过氧化物酶体增殖物激活爱体α/肉碱棕榈酰基转移酶1A通路影响肝细胞脂肪变性[J]. 中华肝脏病杂志, 2016, 24(4):291-296.[17] 17[18] 18[19] 19 [20] 20

快速检索引用检索图表检索高级检索