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目的 :探讨不同剂量胸腺肽治疗慢性乙型病毒性肝炎 (CHB)的疗效差异。方法 :14 6例CHB患者被随机分为4组 (胸腺肽 2 0 0mg组、10 0mg组、2 0mg组及对照组 )。观察 4组患者丙氨酸转移酶 (ALT)复常率、HBeAg阴转率、HBVDNA阴转率及T细胞亚群变化 ,对比并进行显著性检验处理。结果 :4组ALT复常率差异无显著性 (P >0 .0 5 )。临床疗效 (完全应答率 )胸腺肽 2 0 0mg组 (4 2 .1% )、10 0mg组 (3 4.9% )、2 0mg组 (2 6.4% )均优于对照组 (9.7% )。 2 0mg组与对照组疗效差异无显著性 (P >0 .0 5 )、10 0mg组与对照组疗效差异显著 (P <0 .0 5 )、2 0 0mg组与对照组疗效差异非常显著 (P <0 .0 1)。胸腺肽治疗各组T细胞亚群CD4升高、CD8下降、CD4/CD8比值升高且明显优于对照组 (P <0 .0 1) ,10 0mg组优于 2 0mg组 (P <0 .0 5 )。结论 :胸腺肽治疗CHB的剂量 10 0mg/d较好 ,适当增加剂量有助于提高疗效。
Objective: To investigate the therapeutic effect of different doses of thymosin on chronic hepatitis B (CHB). Methods: 146 CHB patients were randomly divided into 4 groups (thymosin 200 mg, 10 0 mg, 20 mg and control group). The changes of alanine aminotransferase (ALT), the negative rate of HBeAg, the negative rate of HBVDNA and T cell subsets in the four groups were observed and compared. Results: There was no significant difference in the rate of ALT between 4 groups (P> 0.05). Clinical efficacy (complete response rate) thymosin 200 mg group (42.1%), 100 mg group (4.9%), 20 mg group (2.64%) were better than the control group (9.7%). There was no significant difference between the 2 0 mg group and the control group (P0.05), the difference between the 10 mg group and the control group was significant (P0.05), and the difference between the 200 mg group and the control group was significant P <0 .0 1). Thymosin treatment of each group T cell subsets CD4 increased CD8 decreased CD4 / CD8 ratio was significantly higher than the control group (P <0.01), 10 0 mg group was better than 20 mg group (P <0 .0 5). Conclusion: Thymosin treatment of CHB dose of 10 0 mg / d is better, the appropriate dose can help to improve the efficacy.