摘要
目的:观察中药芪灵合剂对慢性乙型肝炎(CHB)患者外周血CD4+T淋巴细胞表面程序性死亡1(Programmed death-1,PD-1)及程序性死亡配体1(Programmed death-1 ligand1,PD-L1)表达水平的影响。方法:收集56例CHB患者随机分为芪灵合剂联合拉米夫定片(LAM)治疗组29例和单用LAM对照组27例,于抗病毒治疗的第0、24、48周用流式细胞术检测外周血CD4+T淋巴细胞及其表面的PD-1/PD-L1的表达情况。结果:治疗48周后,治疗组患者HBV DNA转阴率、ALT复常率均高于对照组,与对照组比较,HBV DNA转阴率具有统计学意义(P<0.05)。治疗组患者外周血CD4+T细胞表面PD-1 24周、48周表达水平与治疗前比较逐渐下降;48周时与本组治疗前比较差异有统计学意义(P<0.01),与对照组比较差异有统计学意义(P<0.05)。治疗组患者CD4+T细胞PD-L1 48周后表达水平与治疗前比较差异有统计学意义(P<0.01),与对照组比较差异有统计学意义(P<0.05)。结论:中药芪灵合剂联合LAM能够提高CHB患者HBV DNA转阴率,ALT复常率,其作用机制可能与抑制CD4+T淋巴细胞表面PD-1/PD-L1的表达有关。
Objective： To investigate the dynamic changes that occur in T cell subsets,particularly involving the surface expression of programmed death 1（ PD-1） and programmed death-Ligand 1（ PD-L1）,in response to mixture Qi Ling therapy in patients with chronic hepatitis B（ CHB）. Methods： Fifty-six patients with CHB were random allocation into treatment group（ mixture Qi Ling therapy and lamivudine） and control group（ only lamivudine） in the study. All the CHB patients at treatment weeks 0（ baseline）,24 and 48,the level of PD-1 protein expression on the surface of total periphera1 CD4＋T cells was determined by flow cytometry. Results： Over the course of antiviral therapy,after 48 weeks treatment,the ALT normalization rate,HBV DNA negative rate of combination therapy group were statistical significanc higher then the control group（ P〈0.05）. After 48 weeks＇ treatment,the combination therapy group of PD-1 /PD-L1 expression leve1 in CD4＋T cell was down（ P〈 0. 01）,and there were statistical significance compared with the control group,（ P〈0.05）. Conclusion： The ability of mixture Qi Ling therapy based antiviral therapy to suppress HBV DNA replication may involve reduction of PD-l /PD-L1 protein expression on the surface of CD4＋T cells.
出处
《中西医结合肝病杂志》
CAS
2014年第4期210-213,共4页
Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases
基金
浙江省中医药管理局重点研究计划(No.2010ZZ005)
浙江省卫生厅医药科技计划项目(No.2012KYB139)
