胸腺法新联合长效干扰素治疗NAs应答不佳的HBeAg阳性慢性乙型肝炎患者的临床疗效OA
The clinical efficacy of thymalfasin combined with long-acting interferon in the treatment of HBeAg-positive chronic hepatitis B patients with poor response to NAs
目的 探讨胸腺法新联合长效干扰素治疗核苷(酸)类似物(NAs)应答不佳的乙型肝炎e抗原(HBeAg)阳性慢性乙型肝炎(CHB)患者的临床疗效.方法 选取2022年1月至2024年6月河北省沧州市第三医院收治的124例经NAs治疗24周应答不佳的HBeAg阳性CHB患者作为研究对象,采用随机数字表法将其分为观察组和对照组,各62例.观察组给予注射用胸腺法新联合聚乙二醇干扰素α-2b治疗,对照组单用聚乙二醇干扰素α-2b治疗,2组均连续治疗48周.比较2组临床疗效、不良反应发生情况及治疗前后乙型肝炎表面抗原(HBsAg)转阴率、HBeAg转阴率、HBeAg转换率、HBV DNA转阴率及外周血T细胞亚群、肝功能指标[丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)].结果 观察组总有效率高于对照组(P＜0.05).观察组HBeAg转阴率、HBeAg转换率和HBV DNA转阴率高于对照组,差异均有统计学意义(P＜0.05).治疗后2组CD3+、CD4+T细胞比例及CD4+T细胞/CD8+T细胞比值高于治疗前,且观察组高于对照组,差异均有统计学意义(P＜0.05).治疗后2组CD8+T细胞比例低于治疗前,且观察组低于对照组,差异均有统计学意义(P＜0.05).治疗后2组血清ALT、AST水平低于治疗前,且观察组低于对照组,差异均有统计学意义(P＜0.05).2组疲乏感、流感样症状、消化道症状等各项不良反应发生率比较,差异均无统计学意义(P＞0.05).结论 注射用胸腺法新联合聚乙二醇干扰素α-2b治疗NAs应答不佳的HBeAg阳性CHB患者能有效改善细胞免疫功能及肝功能,提高临床疗效.
Objective To explore the clinical efficacy of thymalfasin combined with long-acting interferon in the treatment of hepatitis B e antigen(HBeAg)-positive chronic hepatitis B(CHB)patients with poor re-sponse to nucleoside(acid)analogues(NAs).Methods From January 2022 to June 2024,124 patients with HBeAg-positive CHB who did not respond to NAs treatment for 24 weeks in the Third Hospital of Cangzhou City were selected as the research subjects.They were randomly divided into the observation group and the control group,with 62 cases in each group.The observation group was treated with thymalfasin for injection combined with pegylated interferon α-2b,while the control group was treated with pegylated interferon α-2b a-lone.Both groups were treated continuously for 48 weeks.The clinical efficacy,occurrence of adverse reactions and HBsAg seroconversion rate,HBeAg seroconversion rate,HBeAg conversion rate,HBV DNA seroconver-sion rate and peripheral blood T lymphocyte subsets and liver function indicators[alanine aminotransferase(ALT),aspartate aminotransferase(AST)]before and after treatment were compared.Results The total ef-fective rate of the observation group was higher than that of the control group(P＜0.05).The HBeAg sero-conversion rate,HBeAg conversion rate,and HBV DNA seroconversion rate of the observation group were higher than those of the control group,and the differences were statistically significant(P＜0.05).After treatment,the proportions of CD3+and CD4+T cells and the ratio of CD4+T cells/CD8+T cells in both groups were higher than those before treatment,and those in the observation group were higher than those in the con-trol group,with statistically significant differences(P＜0.05).The proportions of CD8+T cells in both groups were lower than those before treatment,and that in the observation group was lower than that in the control group,with statistically significant differences(P＜0.05).The levels of serum ALT and AST in both groups were lower than those before treatment,and those in the observation group were lower than those in the con-trol group,with statistically significant differences(P＜0.05).There were no statistically significant differ-ences in the incidence of fatigue,flu-like symptoms,digestive tract symptoms,etc.,among the two groups(P＞0.05).Conclusion Thymalfasin for injection combined with pegylated interferon α-2b in the treatment of HBeAg-positive CHB patients with poor response to NAs can effectively improve cellular immune function and liver function,and improve clinical efficacy.
张君;王晶;刘红;王晓玲
河北省沧州市第三医院肝病六科,河北沧州 061000河北省沧州市第三医院肝病六科,河北沧州 061000河北省沧州市中心医院肝病科,河北沧州 061000河北省沧州市中心医院肝病科,河北沧州 061000
医药卫生
注射用胸腺法新聚乙二醇干扰素α-2b核苷(酸)类似物应答不佳乙型肝炎e抗原慢性乙型肝炎
thymalfasin for injectionpegylated interferon α-2bnucleoside(acid)analoguespoor responsehepatitis B e antigenchronic hepatitis B
《检验医学与临床》 2026 (9)
1202-1208,7
河北省医学科学研究重点课题计划项目(20231128).
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