目的探讨拉米夫定联合胸腺肽对慢性重型乙型肝炎的疗效。方法 58例患者随机分为治疗组29例和对照组29例,两组患者均采用相同的综合性治疗方法及拉米夫定100 mg/d 口服,治疗组加用胸腺肽80 mg/d静脉滴注,疗程2个月后停用胸腺肽,两组存活者均继续口服拉米夫定,疗程2年。结果治疗2个月时,治疗组好转率明显高于对照组(68．9％ vs 27．6％,x2= 13．53,P<0．01),而病死率明显低于对照组(24．1％ vs 51．7％,x2=4．69,P<0．05);存活者治疗组 TBIL、PTA、ALB、NH3及ChE恢复也明显优于对照组(t值为2．51-8．52,均P<0．01);治疗组并发肝性脑病、感染、肝肾综合征、上消化道出血也明显低于对照组(x2值为4．04-10．55,均P<0．05)。 2年疗程结束时治疗组病死率明显低于对照组(24．1％ vs 62．1％,x2=8．51,P<0．01),而存活者2 年疗程结束时及随访6个月时两组ALT复常率及HBV DNA阴转率则差异无统计学意义。结论拉米夫定联合胸腺肽治疗慢性重型乙型肝炎能促进肝功能恢复,减少并发症,降低病死率。 Objective To investigate the curative effect of lamivudine combined with thymosin on chronic severe hepatitis B Methods Fifty-eight patients were randomly divided into treatment group (n = 29) and control group (n = 29). Both groups were treated with the same comprehensive treatment and oral administration of lamivudine (100 mg / d). Thymosin 80 mg / Note, thymosin was discontinued after 2 months of treatment, and both survivors continued oral lamivudine for 2 years. Results At 2 months, the improvement rate of the treatment group was significantly higher than that of the control group (68.9% vs 27.6%, x2 = 13.53, P <0.01), but the mortality was significantly lower than that of the control group .1% vs 51.7%, x2 = 4.69, P <0.05). The recovery of TBIL, PTA, ALB, NH3 and ChE in survivors treatment group was also significantly better than that in control group (t = 2.51- 8.52, all P <0.01). Hepatic encephalopathy, infection, hepatorenal syndrome and upper gastrointestinal bleeding in the treatment group were also significantly lower than those in the control group (x2 = 4.04-10.55, P <0.05). At the end of the 2-year course of treatment, the mortality in the treatment group was significantly lower than that in the control group (24.1% vs 62.1%, x2 = 8.51, P <0.01) Month when ALT normalization rate and HBV DNA negative rate was no significant difference. Conclusion Lamivudine combined with thymosin in the treatment of chronic severe hepatitis B can promote liver function recovery, reduce complications and reduce mortality.