阿德福韦酯治疗乙型肝炎肝硬化合并乙型肝炎病毒相关性肾炎的近期疗效  

Adefovir dipivoxil treatment of hepatic cirrhosis complicated with hepatitis B virus associated giomerulonephritis

作　　者：李东复[1] 金珍婧[1] 陈永胜[1] 乔连铭[1] 周键[1] 

机构地区：[1]吉林大学第二医院消化内科,长春130041

出　　处：《中华肝脏病杂志》2008年第5期349-351,共3页Chinese Journal of Hepatology

基　　金：吉林省科技发展计划项目（20060416）

摘　　要：目的观察阿德福韦酯治疗乙型肝炎肝硬化合并乙型肝炎病毒相关性肾炎的近期疗效。方法选择6例乙型肝炎肝硬化合并乙型肝炎病毒相关性肾炎患者，定量PCR测得血清HBVDNA〉10^5拷贝／ml，肾组织HBVDNA阳性，肝功能Child—Pugh分级均为A级，在常规治疗基础上加用阿德福韦酯10mg／d1年。于治疗后1、3、6个月复查血常规、尿蛋白定量、肝肾功能，血清HBV标志物变化情况。结果治疗后3、6个月血清HBVDNA转阴的分别有2例和5例，HBeAg转阴的分别有1例和4例，抗-HBe转阳的均只有1例；ALT复常的分别有5例和6例，总胆红素复常的分别有4例和5例。治疗6个月后尿蛋白量〈0．3g／d的2例，尿蛋白量较治疗前下降〉50％的3例。巩固治疗1年时完全缓解3例，部分缓解2例。结论 阿德福韦酯治疗乙型肝炎肝硬化合并乙型肝炎病毒相关性肾炎近期安全有效。Objective To investigate the efficacy and safety of adefovir dipivoxil （ADV） in treating hepatic cirrhosis complicated with hepatitis B virus associated glomerulonephritis. Methods Six hepatic cirrhosis （Child-Pugh A grade, liver function compensated） patients complicated with hepatitis B virus associated glomerulonephritis diagnosed by renal biopsy, real time PCR and urinary protein tests were treated with ADV for one year in addition to a routine treatment. The dosage of ADV was 100mg daily. Results After 3 and 6 months treatment the negative conversion rates of HBV-DNA were 33.3% and 83.3%; the negative conversion rates of HBeAg were 16.7% and 66.7%; the positive conversion rates of HBeAb were both 16.7%; the recovery rates of ALT were 83.3% and 100.0%; and the recovery rates of TBil were 66.7% and 83.3% respectively. Protein in the urine of two patients was decreased to 0.3 g/d and in three patients it was 50% of the original values. After 1 year treatment the disease subsided fully in 3 and partially in 2 patients. Conclusion Treating hepatic cirrhosis complicated with hepatitis B virus associated glomerulonephritis using adefovir dipivoxil is effective and safe.

关 键 词：肝炎病毒 乙型 肝硬化 肾炎 阿德福韦酯 

分 类 号：R512.62[医药卫生—内科学] R575.2[医药卫生—临床医学]