胸腺五肽联合恩替卡韦治疗免疫耐受期乙型肝炎患者初探

Primary discussion on combination of thymopentin and entecavir in treatment of patients with chronic hepatitis B in immune tolerance period

目的探讨免疫耐受期乙型肝炎患者的抗病毒治疗方案。方法选取宁夏同族自治区人民医院240例慢性乙型肝炎患者,随机分为治疗组与对照组,每组120例,ALT均为20~50 U/L,HBV DNA≥10~4拷贝/ml,均处于免疫耐受期,治疗组患者给予恩替卡韦分散片每日口服0.5 mg,同时皮下注射胸腺五肽粉针每日10 mg,对照组患者仅口服恩替卡韦分散片每日0.5 mg,于治疗4周后检测肝功能、HBV DNA及乙型肝炎病毒血清学标志物。结果治疗组的120例患者中,治疗4周后HBV DNA下降≥1 log_（10）IU/ml者80例,占66.6%,ALT升高至51~80 U/L者40例,占33.3%。对照组患者4周后HBV DNA下降≥1 log_（10）IU/ml者10例,占8.3%,下降≥2 log_（10）IU/ml者0例,差异具有统计学意义（P〈0.05）。结论恩替卡韦联合免疫增强剂胸腺五肽治疗免疫耐受期乙型肝炎患者可取得较好疗效。

Objective To discuss the therapeutic regimen of patients with hepatitis B in immune tolerance period. Methods Total of 240 patients with chronic hepatitis B in Ningxia Hui Autonomous Region People＇s Hospital were selected and divided into treatment group and control group, 120 cases in each group. All patients were in immune tolerance period, with ALT 20~50 U/L, HBV DNA ≥ 104 copies/ml. Patients in treatment group were treatd with entecavir 0,5 mg per day, together with thymopentin subcutaneously 10 mg per day, while patients in control group were only treated with enSecavir 0,5 mg per day. Indexes of liver function, HBV DNA and markers of hepatitis B virus were detected and compared. Results After 4 weeks of treatment, there were 80 cases （66.6%） with HBV DNA decrease≥ 1 log10 IU/ml, and 40 cases （33.3%） with ALT 51~80 U/L in the treatment group, while there were only 10 cases （8.3%） with HBV DNA decrease ≥ 1 log10 IU/ml and 0 case with HBV DNA decrease ≥ 2 log10 IU/ml in control group. Conclusion The combination use of thymopentin and entecavir in treatment of patients with chronic hepatitis B in immune tolerance period may be effective.