【作者】 李耀才； 陈小萍； 伍思国； 杨静； 何国锋；

【Author】 LI Yaocai CHEN Xiaoping WU Siguo.Maoming city people hospital,Maoming Guandong,525000.

【机构】 广东省茂名市人民医院感染科；

【摘要】 目的:探讨拉米夫定联合胸腺肽对慢性重型乙型肝炎的疗效。方法:58例患者随机分为治疗组29例和对照组29例,两组患者均采用相同的综合性治疗方法及拉米夫定100mg/d 口服,治疗组加用胸腺肽80mg/d 静脉滴注,疗程2个月后停用胸腺肽,两组存活者均继续口服拉米夫定,疗程2年。结果: 治疗2个月时,治疗组好转率明显高于对照组（68.9%vs27.6%,X²=13.53,P<0.01）,而病死率明显低于对照组（24.1%vs51.7%,X²=4.69,P<0.05）;存活者治疗组 TBIL、PTA、ALB、NH₃及 ChE 恢复也明显优于对照组（t 值为2.51～8.52,均 P<0.01）;治疗组并发肝性脑病、感染、肝肾综合征、上消化道出血也明显低于对照组（X²值为4.04～10.55,均 P<0.05）。2年疗程结束时治疗组死病率明显低于对照组（24.1% vs62.1%,X²=8.51,P<0.01）,而存活者2年疗程结束时及随访6个月时两组 ALT 复常率及 HBV DNA 阴转率则差异无统计学意义。结论:拉米夫定联合胸腺肽治疗慢性重型乙型肝炎能促进肝功能恢复,减少并发症, 降低病死率。更多还原

【Abstract】 Objective To study the effect of lamivudine combined with thymosin treatment on patients with chronic severe hepatitis B.Methods 58 patients with chronic severe hepatitis B were randomly divided into two groups （treated group and control group）.All patients （29 in treated group and 29 in control group） were treated with synthesized therapy for 2 months and lamivudine 100mg/d for 2 years,in addition,the patients in treated group were treated with thymosin 80mg/d at first 2 months.Results After 2 months,the improvement rate of the treated group was higher than that of the control group significantly（68.9%vs27.6%,X²=13.53,P<0.01）,and the mortality rate of the treated group was lower than that of the control group significantly（24.1%vs51.7%,X²=4.69, P<0.05）,and the degree of the improvement of TBIL,PTA,ALB,NH₃ and ChE of the treated group were better than that of the control group significantly（t-value 2.51～8.52,P<0.01）,and hepatic encephalopathy, infection,renal failure,upper gastrointestinal bleeding of the treated group were lower than that of the control group significantly（X²=4.04～10.55,P<0.05）.It was found that the mortality rate of the treated group was lower than that of the control group significantly after 2 years（24.1% vs 62.1%,X²=8.51,P<0.01）,but the ALT normal-rat and HBV DNA negative-conversion-rat were not significantly between the treated group and the control group after 2 years and after 6 months follow-up.Conclusions Lamivudine combined with thymosin therapy can improve liver function,and decrease mortality and complications on patients with chronic severe hepatitis B.更多还原