替比夫定联合胸腺素α1治疗慢性乙型肝炎的疗效观察

Clinical evaluation on patients with chronic hepatitis B treated with telbivudine and thymosin α1

目的观察替比夫定联合胸腺素α1治疗慢性乙型肝炎的安全性和疗效。方法替比夫定治疗组18例,口服替比夫定,600mg/d;联合治疗组20例,替比夫定(600mg/d)治疗2周,联合胸腺素α1(1.6mg皮下注射,每周2次)治疗26周后单服替比夫定。结果24周时,替比夫定组及联合治疗组的ALT复常率分别为83.3%和85%(P>0.05);HBVDNA检测不到的比率分别为66.7%和75%(P>0.05);HBeAg的血清转换率为27.8%和35%(P>0.05)。48周时,两组的ALT复常率分别为94.5%和95%(P>0.05);HBVDNA检测不到的比率为83.3%和85%(P>0.05);HBeAg的血清转换率则分别为33.5%和50%(P<0.05)。HBeAg血清转换率与治疗前的转氨酶水平、HBeAg和HBVDNA水平有关。耐药的发生率替比夫定组为27.8%,联合治疗组发生率为10%。结论替比夫定联合胸腺素α1治疗慢性乙型肝炎,安全性和耐受性均较好,48周后HBeAg的血清转换率显著高于单用替比夫定组,而耐药发生率显著低于单用替比夫定组。

Objective To evaluate the safety and effect of telbivudine combined with thymosin α1 as antivira/therapy for patients with chronic hepatitis B. Methods Eighteen patients were treated with telbivudine 600 mg per day alone; twenty patients were treated with combination therapy： after treatment with telbivudine for two weeks, thymosin α1 was applied with 1.6 mg intramuscularly per day, twice a week for 26 weeks, combined with the treatment of telbivudine.Results After 24 weeks, the normalization rates of ALT in telbivudine group and combinaiton group were 83.3% and 85% , respectively （ P 〉 0.05 ） ;unde-tectable rates of serum HBV DNA and HBeAg seroeonversion rates were 66.7% and 75% in telbivudine group, 27.8% and 35% in combination group, respectively （ P 〉 0.05 ）. But after 48 weeks, the normalization rates of ALT in telbivudine group and combination group were 94.5% and 95% , respectively （ P 〉 0.05 ） ;undetectable rates of serum HBV DNA and HBeAg seroeonversion rates were 83.3% and 85% in telbivudine group, 33.5%and 50% in combination group, respectively （P 〈0.05 ）. Conclusions The safety and tolerability of thymosin α1 and telbivudine combination are worth considering as a promising antiviral strategy and are more satisfactory than telbivudine alone in the treatment of chronic hepatitis B.