The clinical efficacy and the influence on T cell subsets of telbivudine in the treatment of HBeAg-positive chronic hepatitis B / 中国基层医药

ABSTRACT

Objective To investigate the clinical efficacy and the influence on T cell subsets of telbivudine in the treatment of HBeAg -positive chronic hepatitis B , guide clinical treatment .Methods 70 patients HBeAg -positive chronic hepatitis B in our hospital were randomly divided into the telbivudine group which were received telbi -vudine 600mg/d and lamivudine group which were received lamivudine 100mg/d,35 cases of each group ,both group had been treated for 48 weeks,the liver function (ALT,AST) were detected for making a statistics of ALT normaliza-tion,the serum were extracting for detecting HBV -DNA and making a statistics of HBV -DNA negative rate by PCR,the HbeAg were detected for making a statistics of HBeAg seroconversionby ECLIA ,T cell subsets ( CD3+,CD4+, CD8+,CD4+/CD8+) were detected by flow cytometry ,observed adverse events .Results The ALT,AST,HBV-DNA of the telbivudine group and lamivudine group after treatment were (36.04 ±7.62)U/L and (63.53 ±14.13)U/L, (34.26 ±8.51)U/L and (55.31 ±15.48)U/L,(2.22 ±0.73)copies/mL and (3.28 ±0.95)copies/mL,all indi-cators significantly lower than before treatment (t =24.826,18.564,7.495 and 17.413,13.331,5.442,all P<0.05),and the ALT,AST of the telbivudine group were significantly lower than the lamivudine group ( t=3.867, 3.774,3.498,all P<0.05).The ALT normalization,HBV-DNA negative rate,HBeAg seroconversion rate of the telbivudine group and lamivudine group were 97.14%and 74.29%,94.29%and 68.57%,62.86%and 37.14%, telbivudine group,the telbivudine group were significantly higher than that of lamivudine group (χ2 =7.467,7.652, 4.629,all P<0.05).The CD3+,CD4+,CD4+/CD8+of telbivudine group and lamivudine group after treatment were (66.3 ±3.8)%and (60.6 ±3.5)%,(38.8 ±5.4)% and (35.2 ±4.4)%,(1.33 ±0.16)% and (0.95 ±0.11)%,all indicaitons significantly higher than before treatment ( t =5.442,6.173,3.753 and 3.404,3.635, 3.222,all P <0.05),the telbivudine group were significantly higher than lamivudine group (t =3.473,3.207, 3.422,all P<0.05).Conclusion The telbivudine has better efficacy than the lamivudine in the treatment of HBeAg-positive chronic hepatitis B because of enhancing immune function ,can improves ALT normalization ,HBV-DNA negative rate and HBeAg seroconversion rate ,inhibit HBV replication .