胸腺肽α_1联合拉米夫定治疗慢性乙型肝炎

Clinical Observation on Effect of LAM and Thymosin α_1 for Chronic Hepatitis B

目的探讨拉米夫定(LAM)和胸腺肽α1(Tα1迈普新)联合治疗慢性乙型肝炎52周疗效观察。方法将68例HBVDNA与HBeAg阳性的慢性乙型肝炎患者随机分为2组,LAM+Tα1联合治疗组和单一LAM治疗组。结果治疗52周时LAM+Tα1组HBeAg血清转换率61.3%(19/31)明显高于LAM组20.5%(7/34),P<0.05;HBVDNA转阴率分别为100%(31/31)和91.2%(31/34)联合治疗组下降更明显,但无统计学意义;治疗后两组的丙氨酸氨基转移酶(ALT)复常率分别为90.32%(28/31)和76.67(26/34);治疗52周联合治疗组完全应答率61.3%(19/31)明显高于LAM组20.5%(7/34),P<0.05;治疗过程中LAM组发生YMDD变异3例,发生率8.8%(3/34),联合治疗组未检出。治疗过程中未见明显不良反应。结论LAM与Tα1联合治疗慢性乙型肝炎52周疗程,不良反应少,疗效优于单一应用LAM组。

Objective The curative effect about curing the chronic hepatitis B using LAM and Maipuxin(Thymosin α1,Tα1)during 52 weeks is discussed.Methods 68 chronic hepatitis B patients whose HBVDNA and HBeAg positive are divided into two groups,the LAM+Tα1 treatment group and single LAM group.Results After the treatment 52 weeks,the blood serum transformation rate of LAM+Tα1 treatment group is 61.3%(19/31),significantly higher than that of the LAM group 20.5%(7/34) obviously, P<0.05;HBVDNA negative rate is 100%(31/31) and 91.2%(31/34) respectively for the two groups,the decline of the treatment group is more obvious,but this has no statistics significance;After treatment the nomalization rate of ALT is 90.32%(28/31) and 76.67%(26/34) respectively;afrer treatment 52 weeks,the seroconversion rate of the treatment group is 61.3%(19/31),clearly higher than that of the LAM group 20.5%(7/34), P<0.05;during the course of treatment 3 YMDD mutations occurred in the LAM group,and the incidence is 8.8%(3/34),however no such cases were detected in the treatment group.In the course of treatment no obvious untoward reactions have been detected.Conclusion After 52 weeks of treating the chronic hepatitis B using the LAM and Tα1,the untoward reactions are rare,and the curative effect exceeds the single LAM group.