替比夫定治疗乙型肝炎病毒相关性肾炎的临床研究  

Clinical study on telbivudine in treatment of hepatitis B virus associated glomendonephritis

作　　者：贺晓雯 马刚[2] 

机构地区：[1]西电集团医院肾脏内科,陕西西安710077 [2]西安市唐都医院传染科,陕西西安710038

出　　处：《现代药物与临床》2014年第10期1134-1137,共4页Drugs & Clinic

摘　　要：目的探讨替比夫定治疗乙型肝炎病毒相关性肾炎(HBV-GN)的临床疗效。方法 2011年10月—2013年6月西电集团医院收治的HBV-GN患者64例,随机分为治疗组(32例)和对照组(32例)。两组患者均给与相应的对症治疗,对照组口服拉米夫定片,1片/次,1次/d。治疗组在对症治疗基础上口服替比夫定片,1片/次,1次/d。所有患者均连续治疗12个月。治疗后,对两组的临床疗效进行评价,同时对其肝肾指标进行检测。结果治疗组和对照组的总有效率分别为90.63%、68.75%,两组比较差异有统计学意义(P<0.05)。治疗6个月、治疗后两组患者丙氨酸氨基转氨酶(ALT)、天冬氨酸氨基转氨酶(AST)、总胆红素(STB)、尿素氮(BUN)、血肌酐(Scr)、尿蛋白/肌酐比(Up/cr)均较治疗前显著降低,肾小球滤过率(GFR)、血清白蛋白(Alb)均较治疗前显著升高,同组治疗前后差异有统计学意义(P<0.05),且治疗组各指标的改善程度优于对照组,两组比较差异有统计学意义(P<0.05)。替比夫定对各种HBV-GN均有较好的临床疗效,总有效率均在75%以上,其中对于局灶阶段性肾小球硬化症和硬化性肾小球肾炎的治疗效果最好,总有效率高达100%。结论替比夫定治疗HBV-GN有较好的临床疗效,可改善疾病相关指标,值得推广应用。Objective To investigate the clinical efficacy of telbivudine in the treatment of hepatitis B virus associated glomendonephritis （HBV-GN）. Methods Sixty four patients with HBV-GN in Xi’an XD Group Hospital from October, 2011 to June, 2013 were randomly divided into control （32 cases） and treatment （32 cases） groups, and all the patients were given corresponding symptomatic treatment. Patients in the control group were po administered with Lamivudine Tablets, 1 piece/time, once daily. Patients in the treatment group were po administered with Telbivudine Tablets on the basis of symptomatic treatment, 1 piece/time, once daily. After the treatment, the treatment efficacy was evaluated, while the indexes of liver and kidney were tested. Results The efficacies in the treatment and control groups were 90.63% and 68.75%, respectively, and there were differences between the two groups （P 〈0.05）. The treatment for 6 months, after the treatment, ALT, AST, STB, BUN, Scr, and Up/cr in the two groups were significantly reduced, while GFR and Alb were elevated, and there was significant difference compared with those before the treatment in the same group （P〈0.05）. And these observational indexes in the treatment group were improved better than those in the control group, and there was significant difference between the two groups （P〈0.05）. Telbivudine had better clinical curative effect in the treatment of all kinds of HBV-GN, and total effective rate was over 75%. Telbivudine had the best treatment effect for focal periodic glomerular sclerosis and sclerosing glomerulonephritis, and the total effective rate was up to 100%. Conclusion Telbivudine has a good clinical effect in the treatment of HBV-GN and could improve disease-related indicators, which is worthy of clinical application.

关 键 词：替比夫定片 拉米夫定片 乙肝相关性肾炎 疗效 

分 类 号：R978.7[医药卫生—药品]