目的 觀察阿德福韋酯聯合胸腺五肽治療乙型肝炎病毒e抗原（HBeAg）陽性慢性乙型肝炎2年的療效。 方法 2007年1月－2009年1月間178例慢性乙型肝炎患者隨機分為試驗組91例和對照組87例。試驗組給予胸腺五肽1 mg，隔日皮下注射，療程52周；同時阿德福韋酯10 mg/d口服104周。對照組給予阿德福韋酯10 mg/d，口服104周。治療26、52、104周及停藥52周時，分別檢測血清丙氨酸氨基轉移酶（ALT）、天冬氨酸氨基轉移酶（AST）、乙型肝炎病毒（HBV）DNA含量及HBV血清標志物。 結果 治療52周后，試驗組在ALT復常率、AST復常率、HBV DNA轉陰率、HBeAg轉陰率與HBeAg/HBeAb血清轉換率方面都比對照組高。停藥52周時，試驗組與對照組的ALT復常率、AST復常率、HBV DNA轉陰率、HBeAg轉陰率、HBeAg/HBeAb血清轉換率分別為74.73%與51.72%、75.82%與54.02%、25.27%與8.05%、26.37%與10.34%、18.68%與8.05%（χ2=10.652、9.313、9.421、7.574、4.313，P＜0.05）。 結論 阿德福韋酯聯合胸腺五肽治療HBeAg陽性慢性乙型肝炎比單獨使用阿德福韋酯抗病毒治療效果更好，有助于提高HBeAg/HBeAb血清轉換率，減少停藥后病毒學突破，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.
目的探討圍手術期應用胸腺五肽對行腹腔鏡輔助直腸癌根治術患者的免疫功能的影響。 方法選取2015年1月至2015年4月期間在解放軍總醫院普通外科接受腹腔鏡輔助腹會陰聯合直腸癌根治術患者42例，根據圍手術期是否應用胸腺五肽分為研究組和對照組。對照組在圍手術期間給予常規治療；研究組除按對照組的常規治療外自術前第1 d起給予胸腺五肽2 mg肌注，1次/d，7 d為1個療程。比較患者術前第1 d、術后第1 d及術后第5 d時的靜脈血淋巴細胞計數、免疫球蛋白（IgG、IgA和IgM）及T細胞亞群（CD3+、CD4+、CD8+及CD4+/CD8+）的變化情況。 結果術后第1 d，2組患者淋巴細胞計數、T細胞亞群及免疫球蛋白較術前均明顯降低（P＜0.05）；術后第5 d時，治療組淋巴細胞計數、T細胞亞群（除外CD4+/CD8+）及免疫球蛋白（除外IgA）均明顯高于對照組（P＜0.05），但治療組的各項指標（淋巴細胞計數、免疫球蛋白、T細胞亞群）的變化情況與術前第1 d時比較差異均無統計學意義（P＞0.05），對照組各項指標仍低于術前第1 d（P＜0.05）。 結論行腹腔鏡手術的直腸癌患者圍手術期應用胸腺五肽可以加快患者術后免疫功能的恢復。