胸腺五肽治疗低复制状态慢性乙肝

目的：探讨胸腺五肽治疗低复制状态慢性乙型病毒性肝炎的疗效和安全性。方法：将113例HBV DNA定量检测低于104 copies/ml慢性乙型病毒性肝炎病员按随机化原则分为2组,治疗组59例给予胸腺五肽1mg肌肉注射,每周2次,疗程6月;对照组54例未使用任何药物。检测治疗前后及随访1年时两组患者HBV DNA定量、肝肾功能、乙肝血清标志物及血常规。对比分析两组HBV DNA定量、肝功能、乙肝血清标志物的变化情况。结果：治疗组在胸腺五肽治疗6月后HBV DNA转阴率为84.75%（50/59）,而对照组观察6月后HBV DNA转阴率为7.41%（4/54）,两组比较差异有统计学意义（P〈0.05）。随访1年时治疗组HBV DNA转阴率为69.49%（41/59）,对照组HBV DNA转阴率为12.96%（7/54）。两组比较差异有统计学意义（P〈0.05）。肝功能改善方面：治疗组疗程结束时ALT正常率为71.05%,AST正常率为82.35%;对照组分别为56%,52.38%。两组比较差异有统计学意义（P〈0.05）。随访1年时治疗组ALT正常率为76.32%,AST正常率为85.29%;对照组分别为36%,38.1%。两组比较差异有统计学意义（P〈0.05）。HBV血清标志物变化方面：随访1年时,治疗组中HBsAg阴转2例,HBsAb转阳1例;对照组中HBsAg阴转1例,无HBsAb转阳。两组比较差异无统计学意义（P〉0.05）。结论：胸腺五肽可促进低复制状态慢性乙型病毒性肝炎HBV DNA转阴,抑制乙肝病毒复制,从而改善患者受损肝脏功能,减轻肝内炎症反应。但是,该药对HBsAg血清转换没有明显作用。胸腺五肽临床使用未见严重不良反应,具有较好安全性。

THERAPEUTIC EFFECT OF THYMOPENTIN ON CHRONIC HEPATITIS B WITH LOW VIRAL REPLICATION

Objective： To study the effect and safety of thymopentin on patients with chronic hepatitis B with low viral replication.Methods： 113 chronic hepatitis B patients with HBVDNA quantity lower than 104 copies/ml were divided into two groups randomly.59 cases in the treatment group were treated with thymopentin 1mg twice a week,for 6 months,while 54 cases in the control group did not receive any therapy.The quantity of HBVDNA,hepatic function and HBV marker were tested and compared between two groups after 6 months and 1 year.Results： The negative rate of HBVDNA in the treatment group was 84.75%,higher than that of the control group（7.41%） after 6 months.The negative rate of HBVDNA in the treatment group was 69.49%,higher than that of the control group（12.96%） after 1 year follow-up,it had statistical difference between two groups.The normal rate of ALT and AST of the treatment group（71.05%,82.35%） was higer than that of the control group（28%,28.57%） after 6 months therapy,with statistical difference.But there was no difference in HBsAg convertion in blood between two groups.Conclusions： Thymopentin can reduce HBV level on hepatitis B patients with low viral replication.But it has no effect on HBsAg convertion in blood.And it is safe for Hepatitis B patients.