临床肝胆病杂志Issue(4)：530-533,4.DOI:10.3969/j.issn.1001-5256.2015.04.013
自体细胞因子诱导的杀伤细胞治疗慢性乙型肝炎患者的临床观察
A clinical study of autologous cytokine-induced killer cells in treatment of patients with chronic hepatitis B
摘要
Abstract
Objective To evaluate the safety and efficacy of autologous cytokine-induced killer (CIK)cells in the treatment of patients with chronic hepatitis B (CHB),and to investigate a new therapeutic strategy for CHB.Methods Peripheral blood mononuclear cells were isolated from 84 patients with CHB,and then induced to CIK cells in vitro with cytokines such as interferon-γ,interleukin-2,and mono-clonal antibody against CD3.The autologous CIK cells obtained were infused back into the individual patient.Liver function parameters,se-rum markers,and HBV DNA levels were evaluated before treatment and at 12,24,and 48 weeks after treatment.Fifty patients who received entecavir (ETV)treatment were used as controls.Comparison was made between HBeAg-positive patients and HBeAg-negative patients. Adverse reactions and kidney function were evaluated.Comparison of continuous data between the two groups was made by t test,and com-parison of categorical data was made by chi-square test.Results The alanine aminotransferase (ALT)levels in both HBeAg-positive pa-tients and HBeAg-negative patients in the treatment group decreased as the observation time went on.HBeAg -positive patients in the treatment group had significant lower ALT levels than those in the control group at 12 and 24 weeks after treatment (t=5.03,P<0.01;t=4.72,P<0.01).The treatment group had higher HBeAg clearance rate and seroconversion rate than the control group at each time point. Particularly,there were significant differences in HBeAg clearance rates at 24 and 48 weeks after treatment between the two groups (χ2 =6.85,P<0.05;χ2 =4.83,P<0.05).Both HBeAg-positive patients and HBeAg-negative patients in the treatment group had higher HBV DNA levels and lower incidence rates of undetectable HBV DNA level than those in the control group.However,as the observation time went on,the HBV DNA copy level gradually decreased,and the HBV DNA clearance rate gradually increased in the treatment group.Conclusion The therapy with autologous CIK cells is safe and effective in patients with CHB during 48 weeks after treatment.In spite of a lower HBV DNA clearance rate,this therapy results in higher HBeAg clearance rate and seroconversion rate than ETV therapy as the observation time goes on,which suggests a probably sustainable immune response after treatment with autologous CIK cells.关键词
肝炎,乙型,慢性/细胞因子类/杀伤细胞/恩替卡韦Key words
hepatitis B,chronic/cytokines/killer cells/entecavir分类
医药卫生引用本文复制引用
王少扬,林涛发,刘海周,马卫闽,谢志红..自体细胞因子诱导的杀伤细胞治疗慢性乙型肝炎患者的临床观察[J].临床肝胆病杂志,2015,(4):530-533,4.基金项目
福建省自然科学基金资助项目 （）
