替诺福韦联合胸腺肽肠溶片治疗慢性乙型肝炎对患者血清HBeAg阴转率及免疫功能的影响

Effects of tenofovir combined with thymopeptides enteric-coated tablets on negative conversion rate of serum HBeAg and immune function in patients with chronic hepatitis B

目的探讨替诺福韦联合胸腺肽肠溶片治疗慢性乙型肝炎对患者血清乙型肝炎e抗原(HBeAg)阴转率及免疫功能的改善效果。方法选取2017年4月至2018年7月在滨州市中心医院接受治疗的慢性乙型肝炎患者94例,依据随机数字表法分为对照组和观察组,每组47例。对照组给予替诺福韦进行治疗,观察组在对照组基础上联合胸腺肽肠溶片进行治疗,观察分析两组患者的血清HBeAg阴转率、免疫功能(CD4^+、CD8^+、CD4^+/CD8^+)、肝功能[丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、总胆红素(TBIL)]及不良反应发生情况。结果治疗后6、12个月,观察组血清HBeAg阴转率(53.19%,25/47;65.96%,31/47)均高于对照组(27.66%,13/47;31.91%,15/47),P<0.05;治疗后,观察组CD4^+及CD4^+/CD8^+值均高于对照组,而CD8^+值低于对照组(P<0.05);治疗后,观察组ALT、AST及TBIL水平均低于对照组(P均<0.05)。两组患者不良反应总发生率比较差异未见统计学意义(P>0.05)。结论替诺福韦联合胸腺肽肠溶片治疗慢性乙型肝炎效果显著,提升了患者的血清HBeAg阴转率,且可促进患者免疫功能恢复,改善预后。

Objective To investigate the effects of tenofovir combined with thymopeptides enteric-coated tablets on negative conversion rate of human hepatitis B virus e antigen(HBeAg)and immune function in patients with chronic hepatitis B.Methods Ninety-four patients with chronic hepatitis B who were treated in Binzhou Center Hospital from April 2017 to July 2018 were selected and divided into control group and observation group according to the random number table method,with 47 cases in each group.Patients in the control group were treated with tenofovir,and patients in the observation group were treated with thymopeptides enteric-coated tablets based on the treatment of the control group.The negative conversion rate of HBeAg,immune function assessed by cluster of differentiation(CD)4^+,CD8^+,CD4^+/CD8^+,liver function,assessed by alanine aminotransferase(ALT),glutamic acid transaminase(AST)and total bilirubin(TBIL),and adverse reactions of the two groups were analyzed and compared.Results The negative conversion rates of HBeAg 6 and 12 months after treatment in the observation group(53.19%,25/47;65.96%,31/47)were higher than those in the control group(27.66%,13/47;31.91%,15/47),P<0.05.After treatment,CD4^+and CD4^+/CD8^+values in the observation group were both higher than those in the control group,and CD8^+value was lower than that in the control group,with statistically significant difference(P<0.05).After treatment,levels of ALT,AST and TBIL in the observation group were lower than those in the control group(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusions Tenofovir combined with thymopeptides enteric-coated tablets can significantly improve the negative conversion rate of serum HBeAg in patients with chronic hepatitis B,promote the recovery of immune function and improve the prognosis.