恩替卡韦与阿德福韦酯单药治疗对慢性乙型病毒性肝炎患者肾功能影响的比较  

Effect Comparison of Entecavir and Adefovir as Monotherapy on Renal Function of Patients with Chronic Hepatitis B

作　　者：黄敬彬[1] 刘德昭[2] 黄树生[1] 

机构地区：[1]南方医科大学附属潮州市中心医院,广东潮州521021 [2]中山大学附属第三医院,广东广州510630

出　　处：《中国药业》2016年第14期29-31,共3页China Pharmaceuticals

基　　金：广东省科技计划项目;项目编号:2011B031800058

摘　　要：目的比较恩替卡韦与阿德福韦酯单药治疗对慢性乙型病毒性肝炎(CHB)患者肾功能的影响。方法选取医院2014年至2015年就诊于感染科门诊的CHB患者100例,分别采用恩替卡韦(0.5 mg/d,E组)与阿德福韦酯(10 mg/d,A组)进行单药抗病毒治疗,比较两组治疗前、治疗52周后、治疗104周后时患者丙氨酸氨基转移酶(ALT)复常率、乙型肝炎e抗原(HBe Ag)血清学阴转率、乙型肝炎病毒(HBV)DNA阴转率,以及血清肌酐(Cr)、肾小球滤过率(eG FR)值的变化。结果治疗52周和104周后,两组患者抗HBV及生化学应答情况无显著性差异(P>0.05);两组患者治疗前和治疗52周后的Cr值和eG FR值组间比较均无显著性差异(P>0.05);与治疗前比较,A组患者治疗104周后Cr值明显增高(P<0.05),而e GFR值明显降低(P<0.05);治疗104周后,A组患者Cr值明显高于E组(P<0.05),且e GFR值明显低于E组(P<0.05)。结论恩替卡韦和阿德福韦酯单药治疗CHB抗病毒疗效相似,但阿德福韦酯会引起一定程度的肾功能损害。Objective To compare the effect of entecavir and adefovir administered as monotherapy on renal function of patients with chronic hepatitis B（ CHB）. Methods 100 patients diagnosised with CHB from 2014 to 2015 were selected and divided into two groups： group E（ Entecavir,0. 5 mg / d） and group A（ Adefovir,10 mg / d）. The normalization of ALT,the undetectable rate of HBeA g or HBV DNA,the level of serum creatinine（ Cr） and estimated glomerular filtration rate（ e GFR） were compared from baseline period to post- treatment 52 weeks and 104 weeks. Results After treatment of 52 weeks and 104 weeks,the hepatitis B virus and anti- biochemical response of the two groups showed no significant difference（ P〈0. 05）; there was no significant difference in the Cr and e GFR values between before treatment and after 52 weeks of treatment（ P〈0. 05）; compared with before treatment,the Cr value of group A after 104 weeks was significantly higher（ P〈0. 05）,whereas the eG FR value was significantly lower（ P〈0. 05）; after 104 weeks,the Cr value of group A was significantly higher than group E（ P〈0. 05）,and the e GFR value was significantly lower than group E（ P〈0. 05）. Conclusion Both entecavir and adefovir have similar efficacy in treating CHB,but adefovir may cause a certain degree of damaged on renal function.

关 键 词：慢性乙型病毒性肝炎 恩替卡韦 阿德福韦酯 肾功能 

分 类 号：R969.4[医药卫生—药理学] R978.7[医药卫生—药学]