抗乙肝病毒药物致肾功能损伤的危险因素分析  

Analysis of risk factors of renal function damage induced by anti-hepatitis B virus drugs

作　　者：何鹏园 甘崇杰 许志杰 李春娜[1] HE Pengyuan;GAN Chongjie;XU Zhijie;LI Chun′na(Department of Infectious Disease,the Fifth Affiliated Hospital of Zhongshan University,Guangdong Province,Zhuhai 519000,China)

机构地区：[1]中山大学附属第五医院感染科,广东珠海519000

出　　处：《中国医药导报》2020年第15期67-70,共4页China Medical Herald

基　　金：广东省医学科研究基金项目(A20180185)。

摘　　要：目的分析抗乙肝病毒药物致肾功能损伤的危险因素。方法选取2015年6月~2016年6月中山大学附属第五医院收治的100例慢性乙型病毒型肝炎(CHB)患者作为研究对象,记录所有患者性别、年龄、用药情况,并观察治疗期间估算的肾小球滤过率(eGFR)的变化。记录所有患者治疗期间肾功能损伤的发生率。对抗乙肝病毒药物致肾功能损伤的单因素进行分析,采用logistic回归模型分析抗乙肝病毒药物致肾功能损伤的多因素分析。结果与治疗初期比较,所有患者治疗1、2、3年后eGFR值逐渐下降(P<0.05)。根据肾损伤情况将患者分为肾损伤组(34例)和无肾损伤组(66例)。单因素分析结果显示,年龄、eGFR水平、抗乙肝病毒药物与CHB患者发生肾功能损伤相关(P<0.05);而与性别无关(P>0.05)。纳入logistic回归模型,结果显示,年龄≥40岁、eGFR水平<90 mL/(min·1.73m2)、抗乙肝病毒药物阿德福韦酯(ADV)均是导致CHB患者肾功能损伤的危险因素(P<0.05)。结论年龄≥40岁、eGFR水平<90 mL/(min·1.73m2)、抗乙肝病毒药物ADV均是导致CHB患者肾功能损伤的危险因素,临床可对上述情况加以重视以预防肾功能损伤的发生。Objective To analyze the risk factors of renal function damage caused by anti-hepatitis B virus drugs.Methods A total of 100 cases of chronic hepatitis B(CHB)in the Fifth Affiliated Hospital of Zhongshan University from June 2015 to June 2016 were selected as the research objects.The sex,age and medication status of all patients were recorded,and the changes of estimated glomerular filtration rate(eGFR)in all patients during treatment was observed during treatment.The incidence of renal impairment was recorded in all patients during treatment.The single factor analysis of renal function damage caused by anti-hepatitis B virus drugs was analyzed.Logistic regression model was used to analyze the multi-factor analysis of renal function damage caused by anti-hepatitis B virus drugs.Results Compared with the initial treatment,the eGFR values of all patients decreased gradually after 1,2 and 3 years of treatment(P<0.05).According to the condition of kidney injury,the patients were divided into kidney injury group(34 cases)and non-kidney injury group(66 cases).Univariate analysis showed that age,eGFR level,anti-hepatitis B virus drugs were associated with renal impairment in patients with CHB(P<0.05),but there was no correlation with gender(P>0.05).Logistic regression model was included.The results showed that age≥40 years old,eGFR<90 mL/(min·1.73m2)and the anti-hepatitis B virus drug Adefovir Dipivoxil(ADV)were the risk factors of renal dysfunction in CHB patients(P<0.05).Conclusion Age≥40 years old,eGFR level<90 mL/(min·1.73m2)and anti-hepatitis B virus drugs ADV are risk factors for renal function damage in CHB patients.Clinical can pay attention to the above situation to prevent the occurrence of renal injury.

关 键 词：抗乙肝病毒药物 肾功能 损伤 慢性乙型病毒型肝炎 危险因素 

分 类 号：R521.7[医药卫生—内科学]