乙型肝炎病毒感染伴焦虑患者体内免疫应答研究*

Effect of anxiety disorder on immune response in patients with chronic hepatitis B*

摘要:

目的 探究乙型肝炎病毒感染伴焦虑患者在治疗过程中机体免疫功能的变化，为指导治疗提供理论依据。方法 选取2015年1月—2017年1月云南省第三人民医院慢性乙型肝炎患者90例。根据是否合并焦虑症分为焦虑组和对照组，每组45例，均给予阿德福韦酯联合胸腺肽治疗。另选取该院45例健康志愿者作为空白组，比较3组治疗前后细胞免疫指标、红细胞免疫指标及炎症因子水平。结果 治疗前与治疗12周后3组白细胞介素-2（IL-2）、白细胞介素-4（IL-4）、白细胞介素-10（IL-10）、干扰素（IFN）和肿瘤坏死因子（TNF）水平由高到低依次为空白组、对照组和焦虑组（P?<0.05）。治疗前与治疗12周后3组CD3+ CD4+、CD4+、CD4/CD8、协同肿瘤红细胞花环率（ATERR）、自然肿瘤红细胞花环率（NTERR）及红细胞C3b受体花环率（RBC-C3bRR）水平由高到低依次为空白组、对照组和焦虑组，CD8+和红细胞免疫复合物花环率（RBC-ICR）水平由高到低依次为焦虑组、对照组和空白组（P?<0.05）。与治疗前比较 ，治疗12周后焦虑组和对照组上述指标均有所改善，组内比较差异有统计学意义（P?<0.05）。结论 阿德福韦酯联合胸腺肽治疗对慢性乙肝患者的免疫功能可进行重建，上调Th1和Th2细胞的表达水平，提高细胞免疫及红细胞免疫功能，但焦虑状态对免疫功能的改善产生负性作用。

Abstract:

Objective To explore the effect of anxiety disorder on immune response in patients with chronic hepatitis B. Methods A total of 90 cases with chronic hepatitis B who were admitted in our hospital from Jan. 2015 to Jan. 2017 were selected. They were divided into anxiety group (45 cases) and control group (45 cases). Another 45 healthy volunteers were involved as blank group. All patients received standard treatment of Adefovir dipivoxil and Thymosin. The clinical data was compared among three groups. Results The levels of interleukin-2 (IL-2), interleukin-4 (IL-4), interleukin-10 (IL-10), interferon (IFN) and tumor necrosis factor (TNF) were the lowest in blank group, and the highest in anxiety group after 12 weeks after treatment (P?