胸腺素α1治疗慢性丙型肝炎的临床荟萃分析

A meta-analysis of thymosin alpha-1 in treatment of patients with chronic hepatitis C virus infection

目的研究分析胸腺素α1(thymosin alpha-1,Tα1)对慢性丙型肝炎的治疗作用。方法通过MEDLINE、PUBMED、Blackwell等电子数据库搜寻有关胸腺素α1治疗慢性丙型肝炎的相关资料,加以统计学上的比较、分析、观察及评价其对慢性丙型肝炎的临床治疗效果。结果我们对7个样本共计202例研究胸腺素α1治疗慢性丙型肝炎的随机对照实验进行临床荟萃分析,发现胸腺素α1治疗组的疗效(50%)几乎是对照组(12%)的四倍,在统计学上差别显著。结论胸腺素α1单用或联合其它药物治疗慢性丙型肝炎能取得较好的临床治疗效果,与干扰素和利巴韦林治疗相比较,不仅能有效地减少HCV复制,不良反应少,而且诱导了一个持续的递增的血清ALT复常和HCV RNA的清除。

Objective Trials of thymosin alpha-1 treatment in chronic hepatitis C virus infection have been small and the results have been inconsistent. To conduct a meta-analysis to evaluate the efficacy of thymosin alpha-1 treatment in chronic hepatitis C virus infection. Methods Randomized controlled trials comparing thymosin alpha-1 in the treatment of chronic hepatitis C virus infection were identified through electronic databases such as MEDLINE,PUBMED and Blackwell. Results Seven trials （202 patients） on chronic hepatitis C were identified. The result showed that treatment with thymosin alpha-1 almost quadruples the sustained response rate （50%） compared with controls （ 12% ）. Conclusion Thymosin alpha-1 may be useful as monotherapy or in combination with other antiviral drugs for chronic hepatitis C, and it can effectively reduce HCV replication in CHC patients. Compared with IFN and ribavirin, thymosin alpha-1 which has less side effects is better tolerated and seems to induce a gradual and more sustained normalization of ALT and loss of HCV RNA, but its effects on morbidity and mortality remain to be seen.