薄芝糖肽与胸腺五肽分别联合重组人干扰素α2b治疗HBeAg阳性的慢性乙型肝炎的临床观察
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篇名: 薄芝糖肽与胸腺五肽分别联合重组人干扰素α2b治疗HBeAg阳性的慢性乙型肝炎的临床观察
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摘要: 目的:观察薄芝糖肽和胸腺五肽分别联合重组人干扰素α2b治疗慢性乙型肝炎的疗效及安全性。方法:选择2014年1月-2015年1月我院90例慢性乙型肝炎患者,随机分为A、B、C组,各30例。A组患者给予注射用重组人干扰素α2b(假单胞菌) 500万IU皮下注射,qod;B组患者在A组基础上加用薄芝糖肽注射液4 mL加入5%葡萄糖注射液250 mL中,ivgtt,qd;C组患者在A组基础上加用注射用胸腺五肽2 mg加入5%葡萄糖注射液250 mL中,ivgtt,qd。3组患者均治疗24周。比较3组患者治疗4、8、12、24周丙氨酸转氨酶(ALT)复常率、HBeAg阴转率、HBeAg/抗HBeAg血清转换率(以下简称“HBeAg转换率”)、HBV-DNA阴转率、乙肝表面抗原(HBsAg)和HBV-DNA下降量,治疗24周时的HBsAg阴转率,并记录不良反应的发生情况。结果:治疗4、8、12周,3组患者ALT复常率、HBeAg阴转率、HBeAg转换率、HBsAg下降量比较,差异均无统计学意义(P>0.05)。治疗4周,B组和C组患者HBV-DNA转阴率显著高于A组, C组患者HBV-DNA下降量显著大于A组和B组,差异有统计学意义(P<0.05)。治疗8、12周,B组和C组患者HBV-DNA阴转率和HBV-DNA下降量显著高于A组,差异有统计学意义(P<0.05),但B组与C组间比较,差异无统计学意义(P>0.05)。治疗24周,3组患者ALT复常率、HBeAg转换率、HBsAg下降量及HBsAg阴转率比较,差异均无统计学意义(P>0.05);B组和C组患者HBeAg阴转率、HBV-DNA阴转率和HBV-DNA下降量显著高于A组,差异有统计学意义(P<0.05),但B组与C组间比较,差异无统计学意义(P>0.05)。3组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论:薄芝糖肽和胸腺五肽分别联合重组人干扰素α2b对慢性乙型肝炎具有较好的抑制病毒增殖作用,且在ALT复常率、HBeAg转换率、HBsAg下降量及HBsAg阴转率方面效果相当。
ABSTRACT: OBJECTIVE: To observe the clinical efficacy and safety of recombinant human interferon α2b (rhIFN α2b) combined with bozhi glycopeptides or thymopentin in the treatment of chronic hepatitis B (CHB). METHODS: Ninety HBeAg-positive CHB patients were selected from our hospital during Jan. 2014-Jan. 2015 and then randomly divided into group A, B, C, with 30 cases in each group. Group A was given rhINF α2b for injection (Pseudomonas) 5 million IU subcutaneously, qod; group B was additionally given Bozhi glycopeptides injection 4 mL added into 5% Glucose injection 250 mL, ivgtt, qd, on the basis of group A; group C was additionally given Thymopentin for injection 2 mg added into 5% Glucose injection 250 mL, ivgtt, qd, on the basis of group A. Three groups were treated for 24 weeks. The rate of ALT recovering to normal, negative rate of HBeAg, transformation rate of  HBeAg/anti-HBeAg serum, negative rate of HBV-DNA and the decrease of HBsAg and HBV-DNA were compared among 2 groups after 4, 8, 12, 24 weeks of treatment.  The occurrence of ADR was recorded. RESULTS: After 4, 8, 12 weeks of treatment, there was no statistical significance in the rate of ALT recovering to normal, negative rate of HBeAg, transformation rate of HBeAg and the decrease of HBsAg among 3 groups (P>0.05). After 4 weeks, negative rate of HBV-DNA in group B, C were significantly higher than group A; the decrease of HBV-DNA in group C were more significant than group A and B, with statistical significance (P<0.05). After 8, 12 weeks of treatment, the negative rate of HBV-DNA and the decrease of HBV-DNA in group B, C were significantly higher than group A, with statistical significance (P<0.05); but there was no statistical significance between group B and C (P>0.05). After 24 weeks of treatment, there was no statistical significance in the rate of ALT recovering to normal, transformation rate of HBeAg, the decrease of HBsAg and negative rate of HBsAg among 3 groups (P>0.05). The negative rate of HBsAg, negative rate of HBV-DNA and the decrease of HBV-DNA in group B, C were significantly higher than group A, with statistical significance (P<0.05); there was no statistical significance between group B and C (P>0.05). There was no statistical significance in the incidence of ADR among 3 groups(P>0.05). CONCLUSIONS: rhIFN α2b combined with bozhi glycopeptides or thymopentin shows good  inhibitory effect on CHB, therapeutic efficacies of them are similar in the rate of ALT recovering to normal, but transformation rate of HBeAg, the decrease of HBsAg and negative rate of HBeAg.
期刊: 2017年第28卷第8期
作者: 沈菲,梁玉记
AUTHORS: SHEN Fei,LIANG Yuji
关键字: 慢性乙型肝炎;重组人干扰素α2b;薄芝糖肽;胸腺五肽;HBeAg阳性
KEYWORDS: Chronic hepatitis B; Recombinant human interferon α2b; Bozhi glycopeptides; Thymopentin; HBeAg positive
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