阿德福韦酯联合胸腺肽胶囊治疗失代偿期肝硬化临床疗效观察

目的观察阿德福韦酯联合胸腺肽肠溶胶囊治疗慢性乙型肝炎肝硬化失代偿期患者的疗效和安全性。方法选择HBsAg、HBeAg和HBcAb阳性、HBVDNA〉10^5copies／mL的肝硬化失代偿期患者56例，随机分为2组，一组采用普通保肝对症治疗，另一组在保肝对症治疗的基础上加用阿德福韦联合胸腺肽肠溶胶囊抗病毒治疗。结果治疗前两组各项指标无明显差异，而治疗后6月ALT复常率、HBVDNA转阴率（〈10^3 copies／mL）、HBeAg转阴率、HBeAg／抗HBe转化率在治疗组分别为72．4％、44．8％、31．0％、13．8％，而对照组分别为33．3％、0％、3．7％、0％，两组间有显著性差异（P〈0．05）；治疗组临床症状明显改善的患者比例是86．2％，显著高于对照组55．6％（P〈0．05）；治疗组治疗期间死亡、消化道大出血、肝性脑病、感染、肝肾综合症的发生率分别为3．4％、3．4％、0％、3．4％、0％，而对照组分别是16．7％，18．5％，7．4％，33．3％，16．7％，两组间相比有显著性差异（P〈0．05）。未观察到明显的不良反应。结论阿德福韦联合胸腺肽肠溶胶囊治疗肝硬化失代偿期患者的疗效肯定，安全性好。

The observation of clinical effectiveness of adefovir combined thymosin capsule treatment in patients with de-compensated cirrhosis

Objective This study was aimed to observe the effects and safety of adefovir combined thymosin capsule therapy in patients with decompensated cirrhosis caused by chronic hepatitis B. Methods 56 decompensated cirrhosis patients with HBsAg,HBeAg,HBcAb-positive and HBV DNA level>105copies/mL were randomly divided into conventional therapy group and group with adefovie combined thymosin capsule treatment. The clinical effectiveness after 6 months was observed. Results The rates of serum ALT normalization,HBV DNA levels undetectable(<103copies/mL),HBeAg seronegative and seroconversion were 72.4%,44.8%,31.0%,13.8% in adefovie combined thymosin capsule treatment group and 33.4%,0%,3.7%,0% in control group,respectively,after 6 months(P<0.05). The incidence rates of death,haemorrhage,hepatocerebral disease,infection,renopathy were 3.4%,3.4%,0%,3.4%,0% in adefovie combined thymosin capsule treatment group,while 16.7%,18.5%,7.4%,33.3%,16.7% in control group. There was no evidence of renal toxicity. Conclusion The effect of adefovir combined thymosin capsule therapy is stable and safe for decompensated cirrhosis.