目的 观察阿德福韦酯联合胸腺五肽治疗乙型肝炎病毒e抗原(HBeAg)阳性慢性乙型肝炎2年的疗效。 方法 2007年1月-2009年1月间178例慢性乙型肝炎患者随机分为试验组91例和对照组87例。试验组给予胸腺五肽1 mg,隔日皮下注射,疗程52周;同时阿德福韦酯10 mg/d口服104周。对照组给予阿德福韦酯10 mg/d,口服104周。治疗26、52、104周及停药52周时,分别检测血清丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、乙型肝炎病毒(HBV)DNA含量及HBV血清标志物。 结果 治疗52周后,试验组在ALT复常率、AST复常率、HBV DNA转阴率、HBeAg转阴率与HBeAg/HBeAb血清转换率方面都比对照组高。停药52周时,试验组与对照组的ALT复常率、AST复常率、HBV DNA转阴率、HBeAg转阴率、HBeAg/HBeAb血清转换率分别为74.73%与51.72%、75.82%与54.02%、25.27%与8.05%、26.37%与10.34%、18.68%与8.05%(χ2=10.652、9.313、9.421、7.574、4.313,P<0.05)。 结论 阿德福韦酯联合胸腺五肽治疗HBeAg阳性慢性乙型肝炎比单独使用阿德福韦酯抗病毒治疗效果更好,有助于提高HBeAg/HBeAb血清转换率,减少停药后病毒学突破,并且使用安全。Objective To evaluate the efficacy of adefovir dipivoxil (ADV) combined with thymopentin on chronic hepatitis B patients with positive hepatitis B e antigen (HBeAg). Methods Between January 2007 and January 2009, 178 chronic hepatitis B patients with positive HBeAg were randomly divided into two groups: the treatment group (91 cases) and the control group (87 cases). All patients in two groups received 10 mg of ADV once a day for 104 weeks, while the patients in the treatment group received 1 mg of thymopentin for subcutaneous injection every other day for 52 weeks. The rates of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) normalization, serum hepatitis B virus (HBV) DNA clearance and HBeAg loss and anti- HBeAg seroconversion were evaluated at pretreatment, and 52, 104 and 156 weeks after treatment, respectively. Results After 52-week treatment, The rates of ALT and AST normalization, serum HBV DNA clearance and HBeAg loss and anti- HBeAg seroconversion in the treatment group were higher than those in the control group. In 52-week follow-up after 104 weeks treatment, the rates of ALT and AST normalization , serum HBV DNA clearance and HBeAg loss and anti- HBeAg seroconversion of two groups were 74.73% versus 51.72%, 75.82% versus 54.02%, 25.27% versus 8.05%, 26.37% versus 10.34%, 18.68% versus 8.05%, respectively (χ2 = 10.652, 9.313, 9.421, 7.574, 4.313; P<0.05). Conclusions It is more effective for adefovir dipivoxil combined with thymopentin on HBeAg-positive patients with chronic hepatitis B than using adefovir alone. Combination treatment could improve the rates of HBeAg seroconversion and reduce the breakthrough of HBV after drug withdrawal. And it is safe.
ObjectiveTo investigate effect of application of thymopentin during perioperative period on immune function of patients undergoing laparoscopic assisted radical resection for rectal carcinoma. MethodsForty-two patients undergoing laparoscopic assisted radical resection for rectal carcinoma from January 2015 to April 2015 in this hospital were collected. These patients were divided into study group and control group. The patients were received routine treatment in the control group. In addition to routine treatment same as the control group, the patients were received 2 mg thymopentin every day for a week in the study group. The changes of lymphocyte count, T lymphocyte subsets (CD3+, CD4+, CD8+, and CD4+/CD8+), and immunoglobulin (IgG, IgA, and IgM) were compared on the 1st day before surgery and on the 1st day and 5th day after surgery. ResultsThe lymphocyte count, T lymphocyte subsets, and immunoglobulin on the first day after surgery were significantly lower than those on the 1st day before surgery in these two groups (P < 0.05). The lymphocyte count, T lymphocyte subsets (except for CD4+/CD8+), and immunoglobulin (except for IgA) in the study group were significantly higher than those in the control group on the 5th day after surgery (P < 0.05). The changes of lymphocyte count, T lymphocyte subsets, and immunoglobulin in the study group had no significant differences between on the 5th day after surgery and on the 1st day before surgery (P > 0.05), but which on the 5th day afer surgery were significantly lower than those on the 1st day before surgery (P < 0.05) in the control group. ConclusionApplication of thymopentin during perioperative period could accelerate recovery of immune function after operation in patients undergoing laparoscopic assisted radical resection for rectal carcinoma.