拉米夫定联合胸腺肽治疗慢性乙型肝炎的疗效观察

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207例HBV DNA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100mg，每日1次，口服，其中甲组92例(92／124)、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＜0．05)，但两组HBV DNA阴转率、HBeAg阴转率及HBeAg／抗—HBe血清转换率均无显著性差异(P＞0．05)。治疗12个月时，甲乙两组ALT复常率和HBV DNA阴转率无显著性差异(P＞0．05)，甲组HBeAg阴转率及HBeAg／抗-HBe血清转换率均显著高于乙组(P＜0．05)。随访结束时，甲组从量复常率、HBV DNA阴转率、HBeAg阴转率及HBeAg／抗—HBe血清转换率均显著高于乙组(P＜0．05)。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。

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

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.