拉米夫定联合胸腺肽α1治疗慢性乙型肝炎

Treatment of Chronic Hepatitis B by Lamivudine Combined With Thymosin-α1

目的观察拉米夫定(LAM)联合胸腺肽α1(Tα1)治疗慢性乙型肝炎的疗效和安全性。方法选择156例HBV-DNA、HBeAg阳性的慢性乙型肝炎患者分为单一使用拉米夫定组(LAM组)和拉米夫定联合胸腺肽α1组(LAM+Tα1组)。结果治疗52周时LAM+Tα1组HBeAg血清转换率38.5%明显高于LAM组11.5%(P<0.05)。HBV-DNA阴转率LAM+Tα1组82.1%明显高于LAM组51.3%(P<0.05)。ALT复常率LAM+Tα1组91.0%明显高于LAM组67.9%(P<0.05)。综合疗效评价LAM+Tα1组完全应答率38.5%明显高于LAM组11.5%(P<0.05)。治疗过程中无明显不良反应,LAM+Tα1组未发生HBV前C区变异株,LAM组发生YMDD变异19例,LAM+Tα1组仅2例。结论 LAM+Tα1治疗慢性乙型肝炎,不良反应少、安全、疗效确切,优于单一LAM治疗。

Objective To analyze the effect and safety of Lamivudine combined with Thymosin-al to treat the patients with chronic hepatitis B（CHB）.Methods A total of 156 patients with CHB were randomly divided into LAM group and LAM＋Tα1 group.Results At 52thweeks,the seroconversion rate of HBeAg was 38.5% in LAM＋Tαl group,which was significantly higher than LAM group（11.5%,P0.05）,the negative conversion rate of HBV-DNA was 82.1% in LAM＋Tαl group,which was significantly higher than LAM group（51.3%,P0.05）,the re-normal rate of ALT was 91.0% in LAM＋Tαl group,which was higher than LAM group（67.9%,P0.05）.No obvious adverse reaction was observed during the treatment.No pre-C variant strain was found in LAM＋Tαl group,YMDD mutation occurred in 19 cases in LAM group,but only 2 in LAM＋Tαl group.Conclusion The treatment of LAM combined with Tα1 for chronic hepatitis B was well tolerated and was more effective than LAM alone.