富马酸替诺福韦二吡呋酯对乙型肝炎病毒载量和肝肾功能影响分析  

Effects of Tenofovir Fumarate Dipivoxil on Hepatitis B Virus Load and Liver and Kidney Function

作　　者：张丰晓[1] 白雪松[1] 胡敬华[1] ZHANG Fengxiao;BAI Xuesong;HU Jinghua(Department of Infection,Zhoukou Central Hospital,Zhoukou City,He’nan Province 460000)

机构地区：[1]河南省周口市中心医院感染科,460000

出　　处：《医学理论与实践》2022年第4期554-557,共4页The Journal of Medical Theory and Practice

摘　　要：目的:评估富马酸替诺福韦二吡呋酯片(TDF)对乙型肝炎病毒载量和肝肾功能影响。方法:采用前瞻性病例对照研究法,选取2018年5月—2020年8月我院感染科118例乙型肝炎患者,按照奇偶数随机分组的原则,随机分为观察组(n=59例)和对照组(n=59例),观察组给予TDF治疗,对照组给予恩替卡韦(ETV)治疗。治疗周期为48周,分别于治疗前和治疗后测定两组外周血中HBV DNA病毒载量(VL)、谷丙转氨酶(ALT)、肾小球滤过率(eGFR)变化情况,通过弹性成像评分判断肝脏硬度。结果:治疗3周后,观察组患者外周血中HBV DNA病毒载量开始显著下降,后期各时间点HBV DNA病毒载量均明显低于对照组(P<0.05);治疗24周和48周后,观察组和对照组ALT、ALT复常率、Scr和eGFR差异不显著(P>0.05);观察组不良反应发生率为11.86%,明显低于对照组的28.81%(P<0.001)。结论:TDF可显著降低乙型肝炎病毒载量,降低肝脏纤维化风险,不良反应小,不会增加肝肾功能损害。Objective:To evaluate the effects of tenofovir fumarate dipivoxil tablets(TDF)on hepatitis B virus load and liver and kidney function.Methods:Using the prospective case-control study method,118 patients with hepatitis B in the infection department of Zhoukou Central Hospital from May 2018 to August 2020 were randomly divided into observation group(n=59 cases)and control group(n=59 cases)according to the principle of odd even random grouping.The observation group was treated with TDF and the control group was treated with entecavir(ETV).The treatment period was 48 weeks.The changes of HBV DNA viral load(VL),alanine aminotransferase(ALT)and glomerular filtration rate(eGFR)in peripheral blood of the two groups were measured before and after treatment,and the liver hardness was judged by elastic imaging score.Results:After 3 weeks of treatment,the HBV DNA viral load in peripheral blood of patients in the observation group began to decrease significantly,and the HBV DNA viral load at each time point in the later stage was significantly lower than that in the control group(P<0.05).After 24 weeks and 48 weeks of treatment,there was no significant difference in ALT,ALT normalization rate,Scr and eGFR between the observation group and the control group(P>0.05).The incidence of adverse reactions in the observation group was 11.86%,which was significantly lower than 28.81%in the control group(P<0.001).Conclusion:TDF can significantly reduce hepatitis B virus load,reduce the risk of liver fibrosis,have less adverse reactions and will not increase the damage of liver and kidney function.

关 键 词：富马酸替诺福韦二吡呋酯 慢性乙型肝炎 肝纤维化 EGFR 肾功能损害 

分 类 号：R512.6[医药卫生—内科学]