生物信息红外肝病治疗仪联合替诺福韦酯对老年慢性乙型肝炎患者肝纤维化指标及血清辅助性T细胞因子水平的影响
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摘要
目的:探讨生物信息红外肝病治疗仪联合替诺福韦酯对老年慢性乙型肝炎患者肝纤维化指标及血清辅助性T细胞(Th细胞)因子水平的影响。方法:选取2016年10月至2018年5月邯郸市传染病医院收治的老年慢性乙型肝炎患者104例,按照随机数字表法分为观察组和对照组,每组52例。对照组患者给予替诺福韦酯治疗,观察组患者给予生物信息红外肝病治疗仪联合替诺福韦酯治疗。对比两组患者临床疗效、血清Th1因子[γ干扰素(IFN-γ)、白细胞介素2(IL-2)]水平、Th2因子[白细胞介素4(IL-4)及白细胞介素10(IL-10)]水平、肝纤维化指标[Ⅳ型胶原(Ⅳ-C)、透明质酸(HA)、Ⅲ型前胶原(PC-Ⅲ)及层粘连蛋白(LN)]水平、肝功能指标[丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、总胆红素(TBIL)及血清白蛋白(ALB)]水平及不良反应发生情况的差异。结果:观察组患者的总有效率为82.69%(43/52),明显高于对照组的61.54%(32/52),差异有统计学意义(P<0.05)。治疗后,观察组患者IFN-γ、IL-2、IL-4及IL-10水平明显优于对照组,差异均有统计学意义(P<0.05)。治疗后,两组患者Ⅳ-C、HA、PC-Ⅲ、LN、ALT及AST水平明显低于对照组,差异均有统计学意义(P<0.05)。观察组、对照组患者不良反应发生率分别为7.69%(4/52)、9.62%(5/52),差异无统计学意义(P>0.05)。结论:生物信息红外肝病治疗仪联合替诺福韦酯能明显改善老年慢性乙型肝炎患者的肝纤维化指标水平,平衡血清Th1/Th2水平,恢复肝功能,且安全性较高。
OBJECTIVE: To investigate the effects of bioinformatics infrared liver disease therapeutic instrument combined with tenofovir disoproxil fumarate on liver fibrosis indexes and serum Th1/Th2 level in elderly patients with chronic hepatitis B. METHODS: 104 elderly patients with chronic hepatitis B admitted into Handan Infectious Disease Hospital from Oct. 2016 to May 2018 were extracted to be divided the observation group and the control group via the random number table, with 52 cases in each group. The control group was treated with tenofovir disoproxil fumarate, and the observation group was treated with tenofovir disoproxil fumarate combined with bioinformatics infrared liver disease therapeutic instrument. Difference of the clinical efficacy, serum Th1 factors such as γ-interferon(IFN-γ), interleukin 2(IL-2) levels, Th2 factors such as interleukin 4(IL-4) and interleukin 10(IL-10) levels, liver fibrosis index such as type Ⅳ collagen(Ⅳ-C), hyaluronic acid(HA), type Ⅲ procollagen(PC-Ⅲ) and laminin(LN) levels, liver function indicators such as alanine] Aminotransferase(ALT), aspartate aminotransferase(AST), total bilirubin(TBIL) and serum albumin(ALB) levels and adverse drug reactions of two groups were compared. RESULTS: The total effective rate in the observation group was 82.69%(43/52), significantly higher than that in the control group 61.54%(32/52), with statistically significant difference(P<0.05). After treatment, the IFN-γ, IL-2, IL-4 and IL-10 levels in the observation group were significantly better than those in the control group, with statistically significant differences(P<0.05). After treatment, the Ⅳ-C, HA, PC-Ⅲ, LN, ALT and AST levels of the observation group were significantly lower than those of the control group, with statistically significant differences(P<0.05). The incidence of adverse drug reactions in the observation group and the control group were 7.69%(4/52) and 9.62%(5/52), respectively, and the difference was not statistically significant(P>0.05). CONCLUSIONS: Bioinformatics infrared liver disease therapeutic instrument combined with tenofovir disoproxil fumarate can significantly improve the level of liver fibrosis in elderly patients with chronic hepatitis B, balance serum Th1/Th2 levels, restore liver function and have higher safety.
OBJECTIVE: To investigate the effects of bioinformatics infrared liver disease therapeutic instrument combined with tenofovir disoproxil fumarate on liver fibrosis indexes and serum Th1/Th2 level in elderly patients with chronic hepatitis B. METHODS: 104 elderly patients with chronic hepatitis B admitted into Handan Infectious Disease Hospital from Oct. 2016 to May 2018 were extracted to be divided the observation group and the control group via the random number table, with 52 cases in each group. The control group was treated with tenofovir disoproxil fumarate, and the observation group was treated with tenofovir disoproxil fumarate combined with bioinformatics infrared liver disease therapeutic instrument. Difference of the clinical efficacy, serum Th1 factors such as γ-interferon(IFN-γ), interleukin 2(IL-2) levels, Th2 factors such as interleukin 4(IL-4) and interleukin 10(IL-10) levels, liver fibrosis index such as type Ⅳ collagen(Ⅳ-C), hyaluronic acid(HA), type Ⅲ procollagen(PC-Ⅲ) and laminin(LN) levels, liver function indicators such as alanine] Aminotransferase(ALT), aspartate aminotransferase(AST), total bilirubin(TBIL) and serum albumin(ALB) levels and adverse drug reactions of two groups were compared. RESULTS: The total effective rate in the observation group was 82.69%(43/52), significantly higher than that in the control group 61.54%(32/52), with statistically significant difference(P<0.05). After treatment, the IFN-γ, IL-2, IL-4 and IL-10 levels in the observation group were significantly better than those in the control group, with statistically significant differences(P<0.05). After treatment, the Ⅳ-C, HA, PC-Ⅲ, LN, ALT and AST levels of the observation group were significantly lower than those of the control group, with statistically significant differences(P<0.05). The incidence of adverse drug reactions in the observation group and the control group were 7.69%(4/52) and 9.62%(5/52), respectively, and the difference was not statistically significant(P>0.05). CONCLUSIONS: Bioinformatics infrared liver disease therapeutic instrument combined with tenofovir disoproxil fumarate can significantly improve the level of liver fibrosis in elderly patients with chronic hepatitis B, balance serum Th1/Th2 levels, restore liver function and have higher safety.
引文
[1] 程琦,施光峰.慢性乙型肝炎治疗进展及新策略[J].传染病信息,2016,29(2):109-112.
[2] 谭俊,周密,胡皓钧,等.替诺福韦酯片对乙肝病毒感染经治患者补救治疗的疗效研究[J].中华医院感染学杂志,2017,27(21):4837-4841.
[3] 张欣,田长印,吴凤萍,等.DSG-Ⅲ型生物信息红外肝病治疗仪治疗慢性肝病31例疗效观察[J].陕西医学杂志,2017,46(10):1419-1421.
[4] 中华医学会肝病学分会.慢性乙型肝炎诊断标准(2015年版)[J].中西医结合肝病杂志,2015,25(6):384-384.
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[6] Kurosaki M,Enomoto N,Asahina Y,et al.Mutations in the core promoter region of hepatitis B virus in patients with chronic hepatitis B[J].J Med Virol,1996,49(2):115-123.
[7] 秦健,李文静,冯勇,等.乙型肝炎、丙型肝炎病毒相关性肝癌基因差异表达的生物信息学分析[J].武汉大学学报医学版,2017,38(4):604-609.
[8] 张瑞凤,姚云洁,游忠岚,等.复方鳖甲软肝片联合恩替卡韦治疗慢性乙型肝炎肝纤维化的观察[J].第三军医大学学报,2014,36(18):1961-1963.
[9] 段雪琳,黎桂玉,李树民,等.复方鳖甲软肝片联合恩替卡韦对慢性乙型肝炎血清肝纤维化标志物影响的Meta分析[J].中国医院药学杂志,2015,35(19):1762-1765.
[10] 刘宁,徐杰,刘金花,等.慢性乙型肝炎、乙肝肝硬化、乙肝肝癌患者Th1/Th2型细胞因子水平变化研究[J].胃肠病学和肝病学杂志,2014,23(2):158-161.
[11] Aloisi F,Ria F,Columba-Cabezas S,et al.Relative efficiency of microglia,astrocytes,dendritic cells and B cells in naive CD4+ T cell priming and Th1/Th2 cell restimulation[J].Eur J Immunol,1999,29(9):2705-2714.
[12] 楚玉兰,顾洪立,兰继,等.慢性乙型肝炎及后期肝病患者外周血T淋巴细胞亚群标志的研究[J].实用预防医学,2016,23(7):873-876.
[13] Saxena R,Kaur J.Th1/Th2 cytokines and their genotypes as predictors of hepatitis B virus related hepatocellular carcinoma[J].World J Hepatol,2015,7(11):1572-1580.
[14] 赵红霞,周建华,张宏宇.慢性乙肝患者血清大蛋白表达及其与Th1/Th2细胞因子水平的关系[J].山东医药,2014,54(26):43-45.
[15] 骆佩怡,唐正运,刘伟东.替诺福韦酯单用治疗慢性乙型肝炎的临床疗效研究[J].中国全科医学,2015,18(34):4216-4219.
[16] 葛瑛,李德明,范韫明,等.替诺福韦酯对抗病毒治疗病毒学应答不佳的慢性乙型肝炎患者疗效[J].中华内科杂志,2014,53(9):697-700.
[17] 唐娟,吴正超,李秋兰,等.肝病治疗仪配合中药穴位敷贴治疗慢性乙型肝炎的疗效观察[J].中西医结合肝病杂志,2014,24(6):367-368.
[2] 谭俊,周密,胡皓钧,等.替诺福韦酯片对乙肝病毒感染经治患者补救治疗的疗效研究[J].中华医院感染学杂志,2017,27(21):4837-4841.
[3] 张欣,田长印,吴凤萍,等.DSG-Ⅲ型生物信息红外肝病治疗仪治疗慢性肝病31例疗效观察[J].陕西医学杂志,2017,46(10):1419-1421.
[4] 中华医学会肝病学分会.慢性乙型肝炎诊断标准(2015年版)[J].中西医结合肝病杂志,2015,25(6):384-384.
[5] 中华医学会传染病与寄生虫病学分会,肝病学分会.病毒性肝炎防治方案[J].中华内科杂志,2001,40(1):62-68.
[6] Kurosaki M,Enomoto N,Asahina Y,et al.Mutations in the core promoter region of hepatitis B virus in patients with chronic hepatitis B[J].J Med Virol,1996,49(2):115-123.
[7] 秦健,李文静,冯勇,等.乙型肝炎、丙型肝炎病毒相关性肝癌基因差异表达的生物信息学分析[J].武汉大学学报医学版,2017,38(4):604-609.
[8] 张瑞凤,姚云洁,游忠岚,等.复方鳖甲软肝片联合恩替卡韦治疗慢性乙型肝炎肝纤维化的观察[J].第三军医大学学报,2014,36(18):1961-1963.
[9] 段雪琳,黎桂玉,李树民,等.复方鳖甲软肝片联合恩替卡韦对慢性乙型肝炎血清肝纤维化标志物影响的Meta分析[J].中国医院药学杂志,2015,35(19):1762-1765.
[10] 刘宁,徐杰,刘金花,等.慢性乙型肝炎、乙肝肝硬化、乙肝肝癌患者Th1/Th2型细胞因子水平变化研究[J].胃肠病学和肝病学杂志,2014,23(2):158-161.
[11] Aloisi F,Ria F,Columba-Cabezas S,et al.Relative efficiency of microglia,astrocytes,dendritic cells and B cells in naive CD4+ T cell priming and Th1/Th2 cell restimulation[J].Eur J Immunol,1999,29(9):2705-2714.
[12] 楚玉兰,顾洪立,兰继,等.慢性乙型肝炎及后期肝病患者外周血T淋巴细胞亚群标志的研究[J].实用预防医学,2016,23(7):873-876.
[13] Saxena R,Kaur J.Th1/Th2 cytokines and their genotypes as predictors of hepatitis B virus related hepatocellular carcinoma[J].World J Hepatol,2015,7(11):1572-1580.
[14] 赵红霞,周建华,张宏宇.慢性乙肝患者血清大蛋白表达及其与Th1/Th2细胞因子水平的关系[J].山东医药,2014,54(26):43-45.
[15] 骆佩怡,唐正运,刘伟东.替诺福韦酯单用治疗慢性乙型肝炎的临床疗效研究[J].中国全科医学,2015,18(34):4216-4219.
[16] 葛瑛,李德明,范韫明,等.替诺福韦酯对抗病毒治疗病毒学应答不佳的慢性乙型肝炎患者疗效[J].中华内科杂志,2014,53(9):697-700.
[17] 唐娟,吴正超,李秋兰,等.肝病治疗仪配合中药穴位敷贴治疗慢性乙型肝炎的疗效观察[J].中西医结合肝病杂志,2014,24(6):367-368.