拉米夫定联合胸腺肽治疗慢性乙型肝炎48例疗效分析

Analysis of the curative effect of lamivudine and thymopolypeptides enteric-coated tablets in treating chronic hepatitis B in 48 cases

目的:观察拉米夫定联合胸腺肽治疗慢性乙型病毒性肝炎(慢乙肝)的临床疗效。方法:96例慢乙肝患者分为两组,治疗组48例予口服拉米夫定每次100 mg,每日1次,连服48周,同时口服胸腺肽肠溶片每次6 mg,每日3次,连服12周;对照组48例单服拉米夫定48周。于治疗第12﹑24﹑48周及停药后20周分别检测两组血清乙肝病毒标志物﹑HBV DNA定量﹑ALT等及观察不良反应。结果:治疗组治疗48周及停药后20周ALT的复常率分别为92%和87%,高于对照组的78%和50%(均为P<0.05);治疗组治疗第12﹑24﹑48周及停药后20周的HBeAg阴转率分别为30%﹑32%﹑43%和35%,高于对照组的7%﹑10%﹑17%和15%(均为P<0.05);治疗组治疗48周及停药后20周的HBV DNA阴转率分别为88%和82%,高于对照组的68%和47%(均为P<0.05)。两组未发现严重不良反应。结论:拉米夫定联合胸腺肽肠溶片治疗慢乙肝比单用拉米夫定能更有效地提高ALT复常率﹑降低血清HBV DNA水平和提高HBeAg阴转率,不良反应轻。

Objective：To observe the clinical curative effect of lamivudine and thymopolypeptides enteric-coated tablets in treating chronic hepatitis B. Methods：96 cases of chronic hepatitis B were divided into two groups,in which 48 cases were given lamivudine at a dose of 100mg orally once a day for consecutive 48 weeks ,while thymopolypetides enteric-coated tablets were given at a dose of 6mg orally three times a day at the same time for consecutive 12 weeks;48 cases as a comparative group took lamivudine only.On the 12th, 24th,and 48th week during treatment as well as 20 weeks after discontinuation of serving the medicine,inspection was carried out to check the serum markers of hepatitis B virus,HBV DNA quantification,and ALT,while observing adverse response. Results：The recovery rate of ALT in the treatment group within 48 weeks of treatment and 20 weeks after discontinuation of medicine was 92% and 87% respectively, which was higher than that in the comparative group,which was 78% and 50% respectively（all P〈0.05）. The treatment group, on the 12th,24th and 48th week during treatment and 20 weeks after discontinuation of medicine,the negative rate of HBeAg was 30%, 32% ,43% and 35% respectively,which was higher than that （7%, 10%, 17% and 15%） in the comparative group （all P〈0.05）;the treatment group,ony the 48th week during treatment and 20 weeks after discontinuation of medicine ,the rate of HBV DNA was 88% and 82% respectively,which was higher than that （68% and 47%） in the comparative group （all P〈0.05）. No adverse response was found in the two groups.Conclusion： Lamivudine combind with thymopolypeptides enteric-coated tablets is able to effectively increase the ALT recovery rate, reduce the level of blood serum HBVDNA and increase the negative rate of HBeAg, with very light bad response.