阿德福韦酯在治疗肝病中的肾脏-骨骼损害作用  

Renal and skeletal injury induced by adefovir dipivoxil in treatment of liver diseases

作　　者：付宽[1] 孙凤霞[1] 李晓玲[1] 蔡皓东[2] 

机构地区：[1]首都医科大学附属北京中医医院肝病科,北京100010 [2]首都医科大学附属北京地坛医院门诊,北京100015

出　　处：《中国肝脏病杂志（电子版）》2016年第3期30-33,共4页Chinese Journal of Liver Diseases：Electronic Version

基　　金：北京市高层次卫生技术人才培养计划(2013-3-024)

摘　　要：阿德福韦酯是我国常用的抗乙型肝炎病毒的药物,然而近年来常有该药引起不良反应的报道。在临床观察中,随着用药时间的延长,肾脏-骨骼损害不良事件的发生率增高。该药的肾损害作用可能与肾近曲小管的阴离子转运蛋白(HOAT-1)、多重耐药蛋白-2(MRP2)以及线粒体的损害有关。常见的临床表现有血肌酐水平升高、低磷血症及并发的骨软化症。在该药的临床应用中,需规律监测患者的血磷、肾小球滤过率和血肌酐水平,一旦出现不良反应,需采取停药或减低药物剂量及补充支持治疗等措施。Adefovir dipivoxil（ADV） is widely used for anti-HBV treatment in China. But in recent years, there are several reports of its adverse events. In addition, the follow-up of chronic hepatitis B patients who were treated with ADV showed that the treatment has a risk of renal damage. It may be attributed to the accumulation of human renal organic anion transporter 1（HOAT-1）, the restriction of multidrug resistance protein 2（MRP2） and mitochondria damaged in renal tubules cells. The common clinical manifestations include abnormal serum creatinine concentrations, hypophosphatemia and secondary osteomalacia. In clinical treatment, regular monitoring of serum phosphate, estimated glomerular filtration rate（eGFR） and serum creatinine is necessary. In case of renal dysfunction, drug discontinuation, dosage reduction or supportive treatment should be taken.

关 键 词：阿德福韦酯 肾脏-骨骼损害 阴离子转运蛋白 多重耐药蛋白-2 高危因素 

分 类 号：R575[医药卫生—消化系统]