拉米夫定联合胸腺肽治疗慢性乙型肝炎的疗效观察  

Clinical evaluation of lamivudine combined with thymopeptide as antiviral therapy for patients with chronic hepatitis B

作　　者：甘雪婷[1] 白宪光[1] 罗红[1] 

机构地区：[1]第四军医大学唐都医院感染科,西安710038

出　　处：《临床内科杂志》2003年第5期248-250,共3页Journal of Clinical Internal Medicine

摘　　要：目的　评价拉米夫定联合胸腺肽治疗慢性乙型肝炎 (CHB)的近、远期疗效和安全性 ,探讨两者联合治疗的协同作用。方法　将 2 0 7例HBVDNA及HBeAg阳性的CHB患者随机分为甲乙两组 ,甲组采用拉米夫定和胸腺肽联合治疗 ,乙组单用拉米夫定治疗。胸腺肽 15mg口服 ,每日 1次 ,疗程 6个月。两组拉米夫定治疗均为 10 0mg ,每日 1次 ,口服 ,其中甲组 92例 ( 92 /12 4)、乙组 70例 ( 70 /83 )用药超过 12个月。两组在治疗 6个月、12个月时分别进行疗效评价 ,治疗结束后继续随访 12个月。结果　治疗 6个月时 ,甲乙两组ALT复常率分别为 87.1%和 74.7% ,甲组显著高于乙组 (P <0 .0 5 ) ,但两组HBVDNA阴转率、HBeAg阴转率及HBeAg/抗 HBe血清转换率均无显著性差异 (P >0 .0 5 )。治疗 12个月时 ,甲乙两组ALT复常率和HBVDNA阴转率无显著性差异 (P >0 .0 5 ) ,甲组HBeAg阴转率及HBeAg/抗 HBe血清转换率均显著高于乙组 (P <0 .0 5 )。随访结束时 ,甲组ALT复常率、HBVDNA阴转率、HBeAg阴转率及HBeAg/抗 HBe血清转换率均显著高于乙组 (P <0 .0 5 )。结论　拉米夫定与胸腺肽联合治疗CHB ,疗效明显优于单用拉米夫定 ,是CHB患者安全有效的治疗方法。Objective To study the efficacy and safety of c ombination of lamivudine and thymopeptide in chronic hepatitis B patients with p ositive HBV DNA and HBeAg.Methods Two hundred and seven patients were randomly divided in to group A and B,the patients in group A received thymopeptide 15 mg orally,o nce daily for six months.However,the patients in both groups received lamivudin e 100 mg orally,once daily.92(92/124) of patients in group A and 70(70/83) of patients in group B being treated more than 12 months.All cases were periodicall y evaluated at 6 and 12 months during the treatment,and all patients were follo wed up for 12 months after stopping treatment.Results At 6 months, the normalization rates of ALT were 87.1% in the combination group and 74.7% in lamivudine group( P < 0.05); The loss rates of serum HBV DNA and HBeAg/anti HBe seroconversion rates in both groups were not different( P >0.05).At 12 months,the normalization rates of ALT and loss rates of serum HBV DNA in both groups were not different( P >0.05).The combination group showed more HBeAg loss and HBeAg/ anti HBe seroconversion tha n group A.After the end of followed up,the normalization rates of ALT and loss rates of serum HBV DNA and HBeAg/anti HBe seroconversion rates in group A wer e more than those in group B( P <0.05).Conclusions The combination therapy of lamivudine and thymopept ide is effective and safe in CHB patients.

关 键 词：慢性乙型肝炎 拉米夫定 胸腺肽 联合用药 临床疗效 

分 类 号：R512.62[医药卫生—内科学] R978.7[医药卫生—临床医学]