CAJ | 학술논문

目的：观察应用脐血和自体细胞因子诱导的杀伤细胞（CIK细胞）联合干扰素治疗慢性乙型肝炎（CHB）的安全性和有效性。方法30例CHB患者均为解放军第一0五医院感染科2010年10月-2013年6月住院患者，签署临床实验研究入组同意书后随机分为3组，每组10例，治疗组分别给予脐血或自体CIK细胞移植，同时给予干扰素治疗，对照组仅接受干扰素治疗，观察治疗后4、12周患者外周血ALT、HBV血清学标志物（HBV M）、HBV DNA对数值和CD4＋/CD8＋水平的变化。两样本均数比较采用配对t检验或成组t检验。结果脐血或自体CIK细胞移植后12周，患者外周血ALT、HBeAg、HBV DNA对数值分别为（22．6±14.4）和（32．9±15．3）U/L；（12．5±5．8）和（18．4±8．8）PEIU/ml；（3．2±0．7）和（3．7±0．6），与对照组相比均明显降低（t＝2．80～5．45，P＜0.05）。两治疗组治疗4周后CD4＋和CD4＋/CD8＋水平均较对照组明显升高（t＝2．21～2．43，P＜0．05）；两组移植患者术中均未出现严重不良反应，无与移植相关的严重并发症发生。结论人脐血和自体CIK细胞移植治疗CHB，短期内可明显抑制病毒复制，改善患者肝功能和临床症状，并能提高患者细胞免疫水平，具有良好的安全性。
목적：관찰응용제혈화자체세포인자유도적살상세포（CIK세포）연합간우소치료만성을형간염（CHB）적안전성화유효성。방법30례CHB환자균위해방군제일0오의원감염과2010년10월-2013년6월주원환자，첨서림상실험연구입조동의서후수궤분위3조，매조10례，치료조분별급여제혈혹자체CIK세포이식，동시급여간우소치료，대조조부접수간우소치료，관찰치료후4、12주환자외주혈ALT、HBV혈청학표지물（HBV M）、HBV DNA대수치화CD4＋/CD8＋수평적변화。량양본균수비교채용배대t검험혹성조t검험。결과제혈혹자체CIK세포이식후12주，환자외주혈ALT、HBeAg、HBV DNA대수치분별위（22．6±14.4）화（32．9±15．3）U/L；（12．5±5．8）화（18．4±8．8）PEIU/ml；（3．2±0．7）화（3．7±0．6），여대조조상비균명현강저（t＝2．80～5．45，P＜0.05）。량치료조치료4주후CD4＋화CD4＋/CD8＋수평균교대조조명현승고（t＝2．21～2．43，P＜0．05）；량조이식환자술중균미출현엄중불량반응，무여이식상관적엄중병발증발생。결론인제혈화자체CIK세포이식치료CHB，단기내가명현억제병독복제，개선환자간공능화림상증상，병능제고환자세포면역수평，구유량호적안전성。
Objective To investigate the efficacy and safety of umbilical cord blood (UCB)-derived or autologous cytokine-induced killer (CIK)cells combined with interferon therapy in patients with chronic hepatitis B (CHB).Methods Thirty CHB patients hospitalized in the Department of Infectious Diseases from October 2010 to June 2013 were included in the study.These patients were randomly and equally divid-ed into first and second treatment groups and control group.The first or second treatment group underwent transplantation of UCB-derived or autologous CIK cells combined with interferon therapy;the control group received interferon therapy alone.At 4 and 12 weeks after treatment, alanine aminotransferase (ALT),serum hepatitis B virus (HBV)marker,HBV DNA,and CD4+/CD8 +ratio in peripheral blood were meas-ured.Comparison of means was made by paired t test or independent-samples t test.Results At 12 weeks after transplantation of UCB-de-rived or autologous CIK cells,the first or second treatment group had ALT,HBeAg,and HBV DNA levels of (22.6 ±14.4)or (32.9 ±15.3) U/L,(12.5 ±5.8)or (18.4 ±8.8)PEIU/ml,and (3.2 ±0.7)or (3.7 ±0.6)log10 copies/ml,respectively,significantly lower than those for control group (t=2.80~5.45,P<0.05).At 4 weeks after transplantation,the two treatment groups had significantly increased CD4+levels and CD4+/CD8 +ratios compared with the control group (t=2.21 ~2.43,P<0.05).No severe adverse reactions and transplantation-related severe complications were found in the two treatment groups.Conclusion For CHB patients,transplantation of UCB-derived or autologous CIK cells significantly inhibits virus replication rapidly,improves liver function,relieves clinical symptoms,improves cellular im-munity,and has high safety.