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目的 研究α-干扰素联合胸腺肽治疗慢性乙型病毒性肝炎 (CHB)对肝纤维化的影响。方法 10 0例患者分为 A组 (干扰素联合胸腺肽组 )、 B组 (干扰素组 )、 C组 (一般护肝组 ) ,并据 A、 B两组中 HBV DNA阴转与否分为应答组与无应答组。比较上述五组治疗前后的血清透明质酸 (HA)、层粘蛋白 (L N)、 III型前胶原 (PC III)等肝纤维化指标的变化。结果 A组 HBV DNA的阴转率为 6 5 .0 % ,显著高于 B组 (4 0 .0 % )及 C组 (10 .0 % ) ,A、 B两组治疗后肝纤维化指标均较治疗前有明显改善 (P <0 .0 5或 0 .0 1) ,以 A组显著 ,C组治疗前后三项指标无变化。而治疗后应答组肝纤维化指标较治疗前下降显著 (P <0 .0 1) ,其中 HA、PCIII较无应答组下降明显 (P <0 .0 5 )。结论 A、 B两种治疗方案均能改善 CHB患者肝纤维化程度 ,有很好的抗病毒作用 ,以 A组效果较好 ,且 HBV DNA阴转病例中肝纤维化指标下降明显。
Objective To investigate the effects of interferon-alpha combined with thymosin on hepatic fibrosis in patients with chronic hepatitis B (CHB). Methods One hundred and ten patients were divided into group A (interferon plus thymosin group), group B (interferon group) and group C (general liver protection group). According to whether HBV DNA negative conversion in groups A and B Response group and no response group. The changes of serum hyaluronic acid (HA), laminin (LN), type III procollagen (PCIII) and other liver fibrosis indexes before and after the above five groups were compared. Results The negative conversion rate of HBV DNA in group A was 65.0%, which was significantly higher than that in group B (40.0%) and group C (10.0%). The liver fibrosis indexes in groups A and B Compared with those before treatment, there was a significant improvement (P <0.05 or 0.01) in group A, and there was no change in three indexes before and after treatment in group C. However, the index of liver fibrosis in response group after treatment was significantly lower than that before treatment (P <0.01), in which HA and PCIII decreased significantly compared with non-responders (P <0.05). Conclusion Both treatment A and B can improve the degree of liver fibrosis in patients with CHB, and have good antiviral effect. The effect of group A is better, and the index of liver fibrosis in patients with HBV DNA negative conversion is obviously decreased.