摘要
目的分析恩替卡韦联合胸腺肽α1与单用恩替卡韦治疗慢性乙型肝炎24周以上的临床疗效。方法计算机检索PubMed、The Cochrane Library、万方数据知识服务平台及维普网等数据库,检索时间为建库至2018年1月,检索有关恩替卡韦联合胸腺肽α1治疗慢性乙型肝炎24周以上的研究。其中采用恩替卡韦联合胸腺肽α1治疗者为恩替卡韦联合胸腺肽α1组,采用恩替卡韦治疗者为恩替卡韦组。采用RevMan 5.3软件进行Meta分析。比较两组患者乙型肝炎病毒脱氧核糖核酸(HBV-DNA)阴转率、乙型肝炎E抗原(HBeAg)阴转率、HBeAg转换率、丙氨酸氨基转移酶(ALT)复常率、肝纤维化指标〔血清透明质酸(HA)、层粘连蛋白(LN)、Ⅳ型胶原(IVC)、Ⅲ型前胶原(PCⅢ)〕、ALT水平、天冬氨酸氨基转移酶(AST)水平及不良反应发生情况。结果共纳入14个研究1465例患者。与恩替卡韦组比较,恩替卡韦联合胸腺肽α1组治疗24周以上慢性乙型肝炎患者,明显提高了HBeAg转阴率〔OR=4.04,95%CI(2.92,5.58),P<0.05〕、HBeAg转换率〔OR=3.86,95%CI(2.81,5.30),P<0.05〕和ALT复常率〔OR=4.74,95%CI(3.14,7.17),P<0.05〕;明显降低了肝纤维指标(HA、LN、IV-C、PCⅢ)、ALT及AST水平,但HBV-DNA阴转率〔OR=1.36,95%CI(0.98,1.88),P=0.06〕及不良反应无明显差异。结论现有文献证据表明,恩替卡韦联合胸腺肽α1治疗HBeAg阳性慢性乙型肝炎24周以上临床疗效优于单用恩替卡韦。
Objective To analyze the clinical efficacy of entecavir combined with thymosinα1 and entecavir alone in treating chronic hepatitis B for more than 24 weeks.Methods Databases of PubMed,The Cochrane Library,Wanfang and VIP were searched from inception to January 2018,to search the research on entecavir combined with thymosinα1 in the treatment of chronic hepatitis B for more than 24 weeks.The patients treated with entecavir combined with thymosinα1 were entecavir combined with thymosinα1 group,and those treated with entecavir were entecavir group.Meta-analysis was performed by RevMan 5.3 software.HBV-DNA negative conversion rate,HBeAg negative conversion rate,HBeAg conversion rate,ALT normalization rate,liver fibrosis indexes(HA,LN,IV-C,PCⅢ),ALT level,AST level and adverse reactions were compared between the two groups.Results A total of 14 studies with 1465 patients were included.Compared with entecavir group,entecavir combined with thymosinα1 group significantly increased HBeAg negative conversion rate〔OR=4.04,95%CI(2.92,5.58),P<0.05〕,HBeAg conversion rate〔OR=3.86,95%CI(2.81,5.30),P<0.05〕and ALT normalization rate〔OR=4.74,95%CI(3.14,7.17),P<0.05〕;the liver fiber indexes(HA、LN、IV-C、PCⅢ),ALT and AST levels were significantly decreased,However,the negative conversion rate of HBV-DNA〔OR=1.36,95%CI(0.98,1.88),P=0.06〕and adverse reactions had no significant difference.Conclusion Existing documentary evidence shows that entecavir combined with thymosinα1 is more effective than entecavir alone in treating HBeAg-positive chronic hepatitis B for more than 24 weeks.
作者
左清平
张顺芝
何鸽飞
刘晓慧
袁立
李宁沙
ZUO Qing-ping;ZHANG Shun-zhi;HE Ge-fei(The First Hospital of Changsha,Changsha 410000,China)
出处
《临床合理用药杂志》
2020年第21期1-4,7,共5页
Chinese Journal of Clinical Rational Drug Use
基金
国家自然科学基金青年基金项目(21877029)。
