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目的通过拉米夫定联合胸腺肽α-1治疗乙型重型肝炎,观察实验室检测指标的变化,探索拉米夫定联合胸腺肽α-1治疗乙型重型肝炎的作用机制,从代谢水平、分子水平为乙型重型肝炎的治疗探寻重要依据。方法应用拉米夫定联合胸腺肽α-1治疗本院乙型重型肝炎44例,随机对照组44例。检测入院时、4周、12周肝功能指标:谷丙转氨酶(ALT)、谷草转氨酶(AST)、碱性磷酸酶(ALP)、谷氨酰基转移酶(GGT)、腺苷脱氨酶(ADA)、乳酸脱氢酶(LDH)、前白蛋白(PA)、白蛋白(ALB)、总胆汁酸(TBA)、总胆红素(TB)、直接胆红素(DB)、凝血酶原活动度(PTA);乙肝核酸(HBV-DNA)载量;乙肝两对半(HBV-M)。结果四周后及12周后肝功能指标的好转情况治疗组明显优于对照组;HBV-DNA载量较对照组明显下降或转阴;HBV-M中e抗原阴转率明显高于对照组。结论经过拉米夫定联合胸腺肽α-1治疗乙型重型肝炎,其肝功能指标明显改善,HBV-DNA载量明显下降或转阴;HBV-M中e抗原转阴率较高。因此,拉米夫定联合胸腺肽α-1是治疗乙型重型肝炎的安全、有效的措施。能有效抑制乙肝病毒复制和提高免疫功能的优点,有利于肝细胞的修复、再生和恢复肝脏的各种功能,提高重型肝炎的抢救成功率。
Objective To investigate the mechanism of lamivudine combined with thymosin α-1 in the treatment of severe hepatitis B through lamivudine combined with thymosin α-1 in the treatment of severe hepatitis B, observe the changes of laboratory test indicators, and to explore the mechanism of action of lamivudine combined with thymosin α-1 from the aspects of metabolic level, molecular level For the treatment of severe hepatitis B to explore an important basis. Methods The application of lamivudine combined with thymosin α-1 in our hospital 44 cases of severe hepatitis B, 44 cases of randomized control group. The indexes of liver function such as ALT, AST, ALP, GGT, ADA (ADA) were detected at 4 weeks and 12 weeks after admission. , LDH, ALB, TBA, TB, DB, prothrombin activity, Degree (PTA); Hepatitis B virus (HBV-DNA) load; Hepatitis B two-and-a-half (HBV-M). Results After four weeks and 12 weeks after liver function improvement, the treatment group was significantly better than the control group; HBV-DNA load was significantly decreased or negative than the control group; HBV anti-e antigen negative conversion rate was significantly higher than the control group. Conclusions After lamivudine combined with thymosin alpha-1 in treatment of severe hepatitis B, the indexes of liver function obviously improve and the load of HBV-DNA decrease or turn negative. The e antigen negative rate of HBV-M is higher. Therefore, lamivudine combined with thymosin α-1 is a safe and effective treatment of severe hepatitis B. Can effectively inhibit the advantages of hepatitis B virus replication and improve immune function, is conducive to the repair of liver cells, regeneration and recovery of liver function, improve the success rate of severe hepatitis rescue.