阿德福韦酯加糖皮质激素治疗乙型肝炎病毒相关性肾炎29例  

Adefovir Dipivoxil combined Sugar Corticosteroid Treated 29 Cases of Hepatitis B Virus Associated Glomerulonephritis

作　　者：孙希平[1] 杨谦[1] 曹显刚[1] 

机构地区：[1]潍坊医学院附属青州医院感染科,262500

出　　处：《中国医药指南》2010年第25期8-11,共4页Guide of China Medicine

摘　　要：目的观察阿德福韦酯加糖皮质激素治疗乙型肝炎病毒相关性肾炎(HBV-GN)的近期疗效,寻找一种有效的治疗方案用以指导以后的临床治疗。方法选择29例乙型肝炎病毒相关性肾炎患者,通过肾组织穿刺检查确定病理分型,观察不同病理类型患者,在常规治疗基础上加用阿德福韦酯10mg/d和泼尼松1mg/(kg·d)的近期疗效,于治疗后3、6、9、12个月复查血常规、尿蛋白定量、肝肾功能、血清HBV标志物及HBVDNA变化。结果 HBV-GN病理分型:膜性肾病(MN)12例(41.4%),膜增生性肾炎(MPGN)9例(31.0%),系膜增生性肾炎(MsPGN)6例(21.4%),IgA肾病(IgAN)2例(3.57%)。以阿德福韦酯加糖皮质激素治疗乙型肝炎病毒相关性肾炎总有效率86.2%(25/29),MPGN组有效率为77.8%,低于其余各病理类型组。结论 HBV-GN病理类型以MN和MPGN为主,以阿德福韦酯加糖皮质激素治疗HBV-GN疗效显著、安全、费用低,值得临床推广应用的有效方法。Objective To observe the adefovir dipivoxil combined sugar glucocorticoid treatment of hepatitis B virus associated glomerulonephritis（HBV-GN） of short-term effect,to f ind an effective treatment program to guide the future clinical treatment.Methods 29 cases of hepatitis B virus associated glomerulonephritis patients with renal tissue puncture through inspection to identify pathological types were observed in patients with different pathological types,based on the conventional treatment to use adefovir dipivoxil 10mg /d and prednisone 1mg/（kg·d） in short-term.Analysis the change of blood routine,urinary protein,liver and renal function,serum HBV markers and HBV DNA to evaluate the efficacy in the treatment after review the data on 3month,6month,9month,12 month.Results HBV-GN pathological types：membranous nephropathy（MN） 12 cases（41.4%）,membranoproliferative glomerulonephritis（MPGN） 9 cases（31.0%）,mesangial proliferative glomerulonephritis（MsPGN） 6 cases（21.4 %）,IgA nephropathy（IgAN） 2 cases（3.57%）.The total effective rate of Adefovir dipivoxil combined sugar glucocorticoid in the treatment of hepatitis B virus associated glomerulonephritis was 86.2%（25/29）,the effective rate of MPGN group was 77.8%,which is lower than the remaining group of pathological types.Conclusions HBV-GN pathological types were mainly MN and MPGN.Adefovir dipivoxil combined sugar glucocorticoid treatment of HBV-GN were signif icant eff icay,safety,low cost,it is an effective clinical method.

关 键 词：乙型肝炎病毒相关性肾炎 阿德福韦酯 糖皮质激素 近期疗效 

分 类 号：R692.3[医药卫生—泌尿科学]