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目的：观察和比较恩替卡韦联合胸腺肽α1 治疗HBeAg 阳性慢性乙型肝炎的疗效。方法：选取我院58 例HBeAg 阳性慢性乙型肝炎患者分成联合组和对照组。联合组28 例，初始同时使用恩替卡韦及胸腺肽α1 24 周，之后停胸腺肽α1 继续用恩替卡韦至48 周。对照组30 例，单用恩替卡韦0.5mg／d，48 周。定期检测ALT 复常率，HBV DNA 转阴率，HBeAg／抗HBe 血清转换率，肝纤维化组合，Fibroscan 评分两组在治疗结束时进行疗效评价。结果：24 周时两组ALT 复常率无差异显著性（P＞0.05），联合组和对照组HBV DNA 阴转率在24 周、48 周时均差异有显著性（P＜0.05）。联合组与单用组HBeAg 血清转换率在第24 周、48 周时，两组比较差异均有显著性（P＜0.05）。肝纤维化组合各指标（HA，LN，PIIIP，Ⅳ型胶原），Fibroscan 评分两组治疗48 周后比较差异均有显著性（P＜0.05），且两组治疗前后差异联合组更显著。治疗过程中，未发现明显副作用。结论：恩替卡韦联合胸腺肽α1 治疗HBeAg 阳性慢性乙型肝炎，安全性与耐受性良好，联合组在ALT 复常率，HBeAg 血清转换率和HBV DNA 转阴率，抗肝纤维化的疗效上显著优于单用恩替卡韦组。

英文摘要:

Objective: To observe the effect of entecavir and thymosin α1 treatment HBeAg positive chronic patitis B patients. Methods: 58 HBeAg-positive patients with chronic hepatitis B were divided into combination group(n=28) and control group(n=30). The combination group was treated with entecavir and thymosinα1 for 24 weeks ,and then stopping using thymosinα1 and continuing entecavir until 48 weeks;the control group was given entecavir (0.5mg daily) for 48 weeks, regularly testing the recovery rate ofALT, HBV DNA negative conversion rate, HBeAg/anti-HBe seroconversion rate, combination of hepatic fibrosis. Results: At 24 weeks there were no difference in the recovery rate of ALT between the two groups (P＞0.05), There were respectively significant differences between the two group patients both HBeAg seroconversion rates and HBV DNA negative rate at 24 weeks, 48 weeks (P＜0.05). The levels of liver fibrosis indexes(HA, LN, PIIIP,Ⅳ-collagen)and fibroscan score decreased significantly after treatment for 48 weeks of two treatment groups , The differences were statistically significant (P＜0.05 ). No adverse reaction was reported during the treatment. Conclusions: Entecavir and thymosin α1 for HBeAg positive chronic hepatitis B have a good safety and tolerability , the combination group in the rate of ALT normalization, HBeAg seroconversion and HBV DNA negative rate, the efficacy of hepatic fibrosis is significantly superior to the entecavir group alone.

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