Detection The Change Of Soluble Sera TRAIL In The Treatment Of HBeAg Positive With Telbivudine

Objective By testing HBeAg positive chronic hepatitis B patients the change ofsTRAIL level in serum with telbivudine treatment，at before、4weeks、12weeks、24weeks and48weeks，explore the role of sTRAIL activity in liver inflammation mechanism and for the immunoregulatoryeffects of HBeAg positive chronic hepatitis B with telbivudine treatment. Methods (1) Selected40cases HBeAg positive chronic hepatitis B patients as a treatment group [given telbivudine，(600mg, oral qd)， observe the treatment of48weeks] in ningxia medical university generalhospital and the fifth hospital OF PLA infection department from July2010to February2012.Detecting the serum level of sTRAIL by ELISA，detecting the ALT by automatic biochemi-cal analyzer，detecting the serum HBV-DNA carrying adopting real time fluorescent quqntitypolymerase chain reaction (RT-PCR)；at the same time choosing the health check-up45casesas a control group.(2) in the case of informed consent selected15patients in the treatmentgroup，who had liver biopsy performed before treatment had their liver biopsy recheckedatafter24weeks with telbivudine treatment. Results (1) before treatment，the serumTRAIL、ALT and HBV-DNA levels of the treatment group were higher than the controlgroup (P <0.05) difference was statistically significant；(2) in the treatment group，patientsserum TRAIL respectively made the related to the ALT and HBV-DNA by linear correlationanalysis, serum TRAIL and ALT levels were significantly positive correlation (r=0.91, andP=0.000)，serum TRAIL with serum serum HBV-DNA content of serum was no correlation(r=0.084; P=0.605)；(3) compared with before treatment，the serum TRAIL content at thetreatment of4weeks，12weeks was decreased,while at the treatment of24weeks and48weeks was increased but still below the level of before treatment；Each time pointrespectively compared with before treatment was statistically significant difference (P<0.05).ALT and HBV DNA levels，along with the extension of treatment time was decreased，the difference was statistically significant(P<0.05)；(4)After48weeks of treatment bytelbivudine，9cases of patients in treatment group HBeAg disappears，7cases appears HBeAbconversion (27.5%);(5)After the treatment，liver histopathology recovered at24weeks，condition improved markedly. Conclusion serum TRAIL level in HBeAg positive chronichepatitis B patients significantly increases， its immune damage in the liver play an importantrole in the process. After treatment with telbivudine，serum TRAIL levels droped、viral loadreduced、liver function improved、Clinical symptoms improved.Dynamic monitoring theserum TRAIL level changes was contribution to disease assessment.For telbivudine, in thetreatment of HBeAg positive chronic hepatitis B patients also is worth the clinical promotion.