摘要
目的评价胸腺肽-拉米夫定序贯治疗的抗HBV疗效。方法 190例HBeAg和HBV-DNA阳性的CHB患者,随机分为序贯治疗组51例(先用胸腺肽继用拉米夫定)平均疗程为16.92月;拉胸合用组23例,平均疗程16.87月;单用拉米夫定组116例,平均疗程18.26月。结果序贯治疗组HBV-DNA和HBeAg阴转率及HBeAg/拉HBe血清转换率分别为70.59％和47.06％及39.22％,单用拉米夫定组为40.52％和23.28％及18.97％,两组差异有非常显著意义(P<0.01)。拉胸合用组的HBeAg阴转率和HBeAg/拉HBe血清转换率分别为43.48％和39.13％,亦优于单用拉米夫定组(x^2=4.011和4.504,P<0.05)。HBV YMDD变异发生率序贯治疗组为11.76％,明显低于单用拉米夫定组的36.21％(P<0.01)。停拉米夫定后的复发率序贯治疗组为15.0％,低于单用拉米夫定组的31.82％,但无统计学意义(P>0.05)。结论胸腺肽-拉米夫定序贯治疗CHB有明显的协同作用,抗病毒疗效明显提高,HBV-YMDD变异发生率明显减少,是治疗CHB安全、经济、有效的新方法。
Objective To evaluate the curative affective use of seguantial therapy of thymopeptide and lamivudine in chronic hepatitis B patients with antiviral therapy.Methods 190 cases with positive HBV DNA and HBeAg were randomly divided into groups,116 cases were enrolled to receive lamivudine alone,100mg orally,once daily,the course of treatment in average is 18.26 months.51 cases were enrolled in the se-quantial therapy group,thymopeptide in prior use,20mg i.m or l.v daily dose for 1 to 2 months,then application lamivudine with course of treatmant in average is 16.92 months.23 cases were enrolled in the simultaneous therapy group (lamivudine and thymopeptide),the course of treatment in average is 16.87 months.Results At the end of treatment,complete response (negative HBV DNA/HBeAg and HBeAg seroconver-sion rates) had remarkable significance of occurred difference in sequantial therapy group as compared with lamivudine alone group (70.59%,47.06% and 39.22% vs 40.52%,23.28% and 18.97%,respectively;x2=12.8139,9.4460和7.7169,P<0.01) However,the rate of negative HBeAg and HBeAg seroconversion tate (43.48% and 39.13%) are only in sin multaneous therapy group as compared with lamivudine alone group (x2=4.011 and 4.504,P<0.05) During continuing lamivudine treatment,the incidence of YMDD mutation of HBV poly-merase,about 42/116 (36.21%) in lamivudine alone group and 6/51 (11.76%) in the sequantial therapy group,as showed significant statistical difference in the patients in both groups compared (x2=10.3332,P<0.01).The recurrence rate of the withdrawal,betwenn lamivudine alone group 7/2 (31.82%) and sequantial therapy group 3/2 (15.0%),there was no statistical significance (x2=83.79,P<0.05).Conclusions The results show that siguantial therapy of thymopeptide and lamivudine are effective safe and economic in CHB patients.It discovers that the incidence of HBV YMDD is apparently reduced.The antiviral curative effect elevates more apparendy than lamivudine alone in the treatmen of chronic hepatitis B.
出处
《医学研究通讯》
2004年第3期49-51,共3页
Bulletin of Medical Research
基金
温岭市2003年科技项目
