摘要
目的探讨拉米夫定抗病毒治疗对乙肝合并肺结核患者细胞免疫功能及肝功能的影响。方法选择2010年5月—2014年10月长阳土家族人民医院就诊的190例乙肝合并肺结核患者为研究对象,根据入院时间分为观察组和对照组各95例,观察组根据肝功能水平分为肝功能异常组23例和肝功能正常组72例。对照组予2HRZE/4HR+护肝片+维生素C治疗,观察组在对照组基础上联合使用拉米夫定,比较各组乙肝DNA水平、T淋巴细胞亚群、肝功能。结果治疗后,观察组HBV-DNA水平(4.12±0.24)×10~6copies/mL低于对照组(6.87±0.56)×10~6copies/mL(P<0.05);T淋巴细胞亚群CD4^+、CD4/CD8高于对照组,CD8+低于对照组(P<0.05)。肝功能正常组血清丙氨酸氨基转氨酶、天冬氨酸氨基转氨酶、总胆红素水平均低于肝功能异常组、对照组(P<0.05)。结论拉米夫定抗病毒治疗有助于改善乙肝合并肺结核患者免疫功能,抑制乙肝病毒复制,保护肝功能。
Objective We investigate the influence of lamivudine antiviral therapy on cellular immune function and liver function lesion induced by hepatitis B virus（HBV） of patients with hepatitis B accompanied by tuberculosis. Methods A total of 190 cases of patients with chronic hepatitis B accompanied by tuberculosis admitted to Changyang Tujia Autonomous County People＇s Hospital, May 2010- October 2014 were selected as objects of the study. The patients were divided into observation group and control group according to admission time, with 95 cases in each group. The observation group according to the occurrence of HBV induced liver function damage was divided into 23 cases of liver function damage group and 72 cases of normal liver function group. Patients in the control group were given 2HRZE/4HR, liver-protecting tablets and vitamin C, in addition to these, patients in the observation group were also treated by lamivudine. The quantity of HBV-DNA, T lymphocyte subtype, liver function of the two groups were compared. Results The level of HBV-DNA（4.12±0.24）×10^6copies/mL of the observation group was significantly lower than that of the control group（6.87±0.56）×10^6copies/m L（P〈0.05）; the levels of T lymphocyte subtype CD4^＋ and CD4/CD8 were significantly higher than those of the control group, and the level of CD8^＋ was significantly lower than that of the control group（P〈0.05）; the levels of serum glutamic-pyruvic transaminase（ALT）, aspartate transaminase（AST） and total bilirubin（TBIL） were significantly lower than those of the HBV induced liver injury group and control group（P〈0.05）. Conclusion Lamivudine antiviral therapy is conductive to improving the immune function of patients with hepatitis B accompanied by tuberculosis, inhibiting the replication of HBV, and protecting the liver function.
作者
刘玉林
LIU Yulin(Integrated Chinese and Western Liver Disease Department, Changyang Tujia Autonomous County People＇s Hospital, Changyang, Hubei 443500, Chin)
出处
《中国热带医学》
CAS
2016年第12期1235-1237,共3页
China Tropical Medicine
关键词
慢性乙型肝炎
肺结核
拉米夫定
免疫功能
肝损伤
chronic hepatitis B
tuberculosis
lamivudine
immune function
liver injury
