CAJ | 학술논문

目的探讨体外诱导自体树突状细胞（DC）对 HBeAg阳性慢性乙型肝炎的治疗效果。方法选择 HBeAg阳性的慢性乙型肝炎病例126例，随机分成治疗组（75例）和对照组（51例），治疗组采用自体 DC联合恩替卡韦治疗，对照组仅采用恩替卡韦治疗。抽取患者静脉血50 ml，密度梯度离心法获得单个核细胞，加入含 GM-CSF和 rhIL-4的培养基，隔日换液，培养至第6天加入 HBsAg，4 h后加入 TNF，继续培养1 d收获 DC。取 DC 2 ml，皮下注射和静脉输注各1 ml，连续3个月。两组患者于治疗前和治疗后6个月检测肝功、HBV-DNA 定量及血清乙型肝炎标志物，并将两组各项检测指标进行对比。结果治疗6个月后检测患者 HBeAg/抗-HBe血清转换率，治疗组和对照组分别为30.62%（23/75）和21.4%（11/51），自体 DC联合恩替卡韦治疗 HBeAg阳性的慢性乙型肝炎的效果优于单纯恩替卡韦的治疗。HBV-DNA 滴度检测治疗组为500拷贝/ml，对照组为1400拷贝/ml。两组差异有统计学意义。结论自体 DC联合恩替卡韦治疗 HBeAg阳性的慢性乙型肝炎的效果优于单纯恩替卡韦的治疗。
목적탐토체외유도자체수돌상세포（DC）대 HBeAg양성만성을형간염적치료효과。방법선택 HBeAg양성적만성을형간염병례126례，수궤분성치료조（75례）화대조조（51례），치료조채용자체 DC연합은체잡위치료，대조조부채용은체잡위치료。추취환자정맥혈50 ml，밀도제도리심법획득단개핵세포，가입함 GM-CSF화 rhIL-4적배양기，격일환액，배양지제6천가입 HBsAg，4 h후가입 TNF，계속배양1 d수획 DC。취 DC 2 ml，피하주사화정맥수주각1 ml，련속3개월。량조환자우치료전화치료후6개월검측간공、HBV-DNA 정량급혈청을형간염표지물，병장량조각항검측지표진행대비。결과치료6개월후검측환자 HBeAg/항-HBe혈청전환솔，치료조화대조조분별위30.62%（23/75）화21.4%（11/51），자체 DC연합은체잡위치료 HBeAg양성적만성을형간염적효과우우단순은체잡위적치료。HBV-DNA 적도검측치료조위500고패/ml，대조조위1400고패/ml。량조차이유통계학의의。결론자체 DC연합은체잡위치료 HBeAg양성적만성을형간염적효과우우단순은체잡위적치료。
Objective To investigate the clinical effects of autologous dendritic cells combined with antiviral treatment on HBeAg-positive chronic hepatitis B. MethodsA total of 126 patients with hepatitis Be antigen (HBeAg) positive chronic hepatitis B were assigned to receive autologous Dendritic cells (DCs) and entecavir (ETV) treatment (experiment group including 75 patients) or only ETV group (control group including 51 patients). Mononuclear cells in venous blood of 50 ml extracted from patients were obtained by density gradient centrifugation. DCs were obtanined after the mononuclear cells were cultured with medium containing GM-CSF and rhIL-4, and then added HBsAg and TNF on the sixth day, and lastly continued to cultivate one more day. The treatment of subcutaneous and intravenous injection of 1ml of DCs respectively lasted for 3 months. Liver function and the level of HBV-DNA and serum markers of hepatitis B were examined and compared after the treatment of the two groups. Results The rate of HBeAg seroconversion were 30.62% (23/75) and 21.4% (11/51) in experiment and control group after treatment for six months. The level of HBV-DNA were 500 copies/ml and 1400 copies/ml in experiment and control group, respectively. There existed statistical significance in both of the differences between the two groups. Conclusion In terms of improving HBeAg serological conversion rate,autologous DCs combined with ETV treatment exerts more potent effects on HBeAg-positive chronic hepatitis B as compared to ETV treatment.