目的 探讨替比夫定片对慢性乙肝患者细胞免疫功能的影响。方法 选取西安市北方医院2014年1月-2015年5月收治的慢性乙肝患者126例,根据随机数字表法分为治疗组与对照组各63例,对照组口服恩替卡韦治疗,治疗组口服替比夫定治疗,治疗观察周期为3个月。结果 治疗后治疗组的HBV DNA转阴率和HBeAg阴转率分别为95.2%和71.4%,对照组为81.0%和44.4%,组间对比差异均有统计学意义(P<0.05)。治疗后治疗组与对照组的ALT值分别为(46.09±15.98)U/L和(76.13±19.55)U/L,都明显低于治疗前的(153.20±33.01)U/L和(151.30±26.02)U/L(P<0.05),且治疗组降低程度更多,与对照组比较差异明显(P<0.05)。两组治疗后的血清IL-2值明显上升(P<0.05),而IL-4值明显降低(P<0.05),同时治疗后治疗组的血清IL-2与IL-4值与对照组相比差异也有统计学意义(P<0.05)。治疗后治疗组与对照组的血CD4⁺CD25⁺值分别为(2.22±1.02)%和(3.45±0.98)%,都明显低于治疗前的(4.87±1.22)%和(4.89±1.02)%(P<0.05),同时组间对比差异明显(P<0.05)。结论 替比夫定片治疗慢性乙肝患者能有效提高机体细胞免疫功能,降低血清炎症因子的表达,有利于抑制乙肝病毒的复制与肝功能的恢复,有很好的应用价值。

Objective To investigate the effects of Telbivudine Tablets in cells immune function of chronic hepatitis B patients. Methods Totally 126 cases of chronic hepatitis B from January 2014 to May 2015 in the Northern Hospital of Xi'an City were selected and randomly divided into treatment and control groups with 63 cases in each group. The patients in control group were treated with Entecavir, the patients in treatment group were treated with Telbivudine. The treatment continued for 3 months. Results After treatment, the HBV DNA negative rate and the HBeAg negative conversion rate of the treatment group were 95.2% and 71.4%, while those in the control group were 81.0% and 44.4%, and the differences between the groups were statistically significant (P<0.05). The ALT values of treatment group and control group after treatment were (46.09±15.98) U/L and (76.13±19.55) U/L that were significantly lower than (153.20±33.01) U/L and (151.30±26.02) U/L (P<0.05) before treatment, while the differences between the two groups were statistically significant (P<0.05). The serum IL-2 values increased significantly after treatment (P<0.05), while IL-4 values were significantly lower after treatment (P<0.05), while the serum IL-2 and IL-4 values in the treatment group after treatment compared with the control group were significant differences (P<0.05). The blood CD4⁺ and CD25⁺ values in the treatment group and control group after treatment were (2.22±1.02)% and (3.45±0.98)% that were significantly lower than those before treatment of (4.87±1.22)% and (4.89±1.02)% (P<0.05), while differences between the two groups were significant (P<0.05). Conclusion Telbivudine Tablets in the treatment of chronic hepatitis B patients can improve immune function, reduce the expression of inflammatory factors will help restore suppression of HBV replication and liver function that has very good values.