恩替卡韦联合胸腺肽α1治疗慢性乙型肝炎疗效研究

Curative Effect of Entecavir plus Thymosin α1 for Patients with Chronic Hepatitis B

目的:观察和比较恩替卡韦联合胸腺肽α1治疗HBeAg阳性慢性乙型肝炎的疗效。方法:选取我院58例HBeAg阳性慢性乙型肝炎患者分成联合组和对照组。联合组28例,初始同时使用恩替卡韦及胸腺肽α124周,之后停胸腺肽α1继续用恩替卡韦至48周。对照组30例,单用恩替卡韦0.5mg/d,48周。定期检测ALT复常率,HBVDNA转阴率,HBeAg/抗HBe血清转换率,肝纤维化组合,Fibroscan评分两组在治疗结束时进行疗效评价。结果:24周时两组ALT复常率无差异显著性(P>0.05),联合组和对照组HBV DNA阴转率在24周、48周时均差异有显著性(P<0.05)。联合组与单用组HBeAg血清转换率在第24周、48周时,两组比较差异均有显著性(P<0.05)。肝纤维化组合各指标(HA,LN,PⅢP,Ⅳ型胶原),Fibroscan评分两组治疗48周后比较差异均有显著性(P<0.05),且两组治疗前后差异联合组更显著。治疗过程中,未发现明显副作用。结论:恩替卡韦联合胸腺肽α1治疗HBeAg阳性慢性乙型肝炎,安全性与耐受性良好,联合组在ALT复常率,HBeAg血清转换率和HBV DNA转阴率,抗肝纤维化的疗效上显著优于单用恩替卡韦组。

To observe the effect of entecavir and thymosin ctl treatment HBeAg positive chromc patms B patients. Methods： 58 HBeAg-positive patients with chronic hepatitis B were divided into combination group（n=28） and control group（n=30）. The combination group was treated with entecavir and thymosinα 1 for 24 weeks ,and then stopping using thymosinαl and continuing entecavir until 48 weeks;the control group was given entecavir （0.5rag daily） for 48 weeks, regularly testing the recovery rate of ALT, HBV DNA negative conversion rate, HBeAg/anti-HBe seroconversion rate, combination of hepatic fibrosis. Results： At 24 weeks there were no difference in the recovery rate of ALT between the two groups （P 〉0.05）, There were respectively significant differences between the two group patients both HBeAg seroconversion rates and HBV DNA negative rate at 24 weeks, 48 weeks （P〈0.05）. The levels of liver fibrosis indexes（HA, LN, PIIIP, Ⅳ-collagen）and fibroscan score decreased significantly after treatment for 48 weeks of two treatment groups, The differences were statistically significant （P 〈0.05 ）. No adverse reaction was reported during the treatment. Conclusions： Entecavir and thymosin αl for HBeAg positive chronic hepatitis B have a good safety and tolerability, the combination group in the rate of ALT normalization, HBeAg seroconversion and HBV DNA negative rate, the efficacy of hepatic fibrosis is significantly superior to the entecavir group alone.