胸腺肽α1联合阿德福韦酯治疗活动性乙型肝炎肝硬化的临床观察

Clinical Analysis on Thymosinαl and Adefovir Dipivoxil for the Treatment of Symptomatic Hepatitis B Cirrhosis

目的:探讨胸腺肽α1(迈普新)联合阿德福韦醇治疗活动性乙型肝炎肝硬化的疗效和安全性。方法:选择HBeAg阳性的活动性乙型肝炎肝硬化80例随机分成治疗组和对照组,两组在综合保肝治疗基础上,均给予阿德福韦酯抗病毒治疗,治疗组加用迈普新治疗。结果:治疗52周时,治疗组肝功能(TBil,ALT,ALB)及PTA改善优于对照组(P<0.05),治疗组血清肝纤维化指标(HA,PCⅢ,LN,Ⅳ-C)下降较对照组明显(P<0.05),HBV DNA转阴率治疗组为92.5%(37/40),对照组为70.0%(28/40),两组间差异有显著性(P<0.01),HBeAg阴转率治疗组为32.5%(13/40),对照组为12.5%(5/40),两组间差异有显著性(P<0.05),血清转化率治疗组为17.5%(7/40),对照组为5.0%(2/40),两组之间差异无显著性(P>0.05)。结论:迈普新联合阿德福韦酯治疗活动性乙型肝炎肝硬化能有效控制病毒复制,改善肝功能,从而延缓病情进展,治疗过程未出现严重不良反应,安全性良好。

Objective ： To evaluate the efficacy and safety of Thymosinα 1 （Maipxin） and Adefovir Dipivoxil （ ADV ） in the treatment of symptomatic hepatitis B cirrhosis. Methods：80 symptomatic hepatitis B cirrhosis patients with HBVDNA and HBeAg positive are randomized into treatment group or control group. Both groups received ordinary liver protection and ADV while patients in treatment group took additional Maipxin i Results： After 52 weeks, the treatment group to improve hepatic function （TBIL, ALT, ALB） and PTA was superior to the control group（ P 〈 0. 05 ） ,The effect of treatment group on decreasing HA ,PCⅢ, LN and Ⅳ-C was more obvious than that of the control group（ P 〈0. 05 ）. The clearance rates of HBV DNA in treatment group was 92.5% （37/40）and in control group was 70. 0% （28/40） ;which had significant differences （ P 〈 0. 01 ）. The clearance rates of HBeAg in treatment group were 32. 5% （13/40） and in control group were 12. 5 % （4/40）,which had significant differences（ P 〈0. 05 ）. The blood serum transformation rate in treatment group was 17.5% （7/40） and in control group was 5.0% （2/ 40）, which had no significant differences （ P 〉 0. 05 ）. Conclusions： Treatment with Thymosinα 1 （ Maipxin ） and AdefoVir Dipivoxil （ADV） on symptomatic hepatitis B cirrhosis significantly reduced serum HBV DNA levels,improved hepatic function and delayed the course of symptomatic hepatitis B cirrhosis. The patients tolerated well and no adverse effects were observed.