恩替卡韦对CHB患者外周血T淋巴细胞PD-1水平及

摘要：目的 探讨恩替卡韦对慢性乙型肝炎（CHB）患者外周血T淋巴细胞程序性死亡受体1（PD-1）水平及肝功能的影响。方法 将128例CHB患者随机分为观察组及对照组各64例，对照组患者给予拉米夫定治疗，观察组在对照组基础上给予恩替卡韦治疗。分别于治疗前、治疗后1个月、3个月、6个月、12个月抽取静脉血5 mL，采用荧光定量PCR检测患者血清HBV DNA载量，流式细胞术检测T淋巴细胞PD-1表达水平，全自动化生化分析仪测定患者血清谷草转氨酶（ALT）水平。结果 两组组患者治疗1个月、3个月、6个月、12个月HBV DNA载量、ALT水平、CD4+T细胞PD-1、CD8+ T细胞PD-1水平均低于治疗前（P<0.05）。观察组治疗后1个月、3个月、6个月、12个月HBV DNA载量、ALT水平、CD4+ T细胞PD-1、CD8+ T细胞PD-1水平低于对照组（P<0.05）。结论 恩替卡韦能有效抑制CHB患者外周血CD4+、CD8+ T细胞表面PD-1表达水平，进而抑制HBV DNA复制，改善患者肝功能。

The impact of entecavir on T lymphocytes PD-1 levels in peripheral blood and liver function of CHB patients

Abstract: Objective To investigate the impact of entecavir on the levels of peripheral blood T lymphocytes programmed death receptor 1 (PD-1) and liver function of patients with chronic hepatitis B (CHB). Methods 128 CHB patients were randomly divided into observation group (n=64) and control group (n=64). The control group were treated with lamivudine therapy. The observed group were given entecavir on the basis of the therapy given to control group. The levels of T lymphocytes PD-1 expression in the two groups were detected with flow cytometry, the levels of HBV DNA were detected with quantitative PCR, and the levels of ALT were detected with fully automated biochemical before treatment and one month, three months, six months and 12 months after treatment. Results The levels of HBV DNA load, ALT, CD4+ T cells in PD-1, and CD8+ T cells in PD-1 in the two groups after treatment were lower than before treatment (P<0.05). The levels of HBV DNA load, ALT, CD4+ T cells in PD-1 and CD8+ T cells in PD-1 in observation group at one month, three months, six months and 12 months after treatment were lower than those in the control group (P<0.05). Conclusion Entecavir can effectively inhibit the CD4+ and CD8+ T cell surface PD-1 expression levels, thereby inhibiting HBV DNA replication and improve liver function.