丙酚替诺福韦联合吗替麦考酚酯治疗乙型肝炎相关性免疫球蛋白A肾病的疗效分析  

Efficacy analysis of tenofovir alafenamide combined with mycophenolate mofetil in the treatment of hepatitis B-related Immunoglobulin A nephropathy

作　　者：姜丽[1] 谢梅[2] 乔旭东 JIANG Li;XIE Mei;QIAO Xudong(Yan'an Vocational and Technical College Faculty of Medicine,Yan'an 716099,Shanxi Province,China;Department of Infections Dseases Yan'an People's Hospital,Yan'an 716099,Shaanxi Province,China;Department of Ultrasound Medicine,Xi'an Ninth Hospital,Xian 710054,Shaanxi Province,China)

机构地区：[1]延安职业技术学院医学系,陕西延安716099 [2]延安市人民医院感染科,陕西延安716099 [3]西安市第九医院超声医学科,陕西西安710054

出　　处：《世界临床药物》2022年第7期863-867,共5页World Clinical Drug

摘　　要：目的探讨丙酚替诺福韦联合吗替麦考酚酯治疗乙型肝炎相关性免疫球蛋白(immunoglobulin,Ig)A肾病疗效。方法纳入2016年2月至2020年2月我院收治的乙型肝炎相关性IgA肾病患者共计82例,对其进行病历资料回顾性分析,将采用丙酚替诺福韦治疗的41例患者设为对照组,丙酚替诺福韦联合吗替麦考酚酯治疗的41例患者设为研究组。比较两组临床疗效,对比分析治疗前后两组肝肾功能及乙型肝炎病毒(hepatitis B virus,HBV)血清标志物水平。结果研究组总有效率为95.12%,显著高于对照组78.05%(P<0.05)。治疗后,两组24 h尿蛋白定量(24-hour urinary protein quantification,24-UCFP)、谷丙转氨酶(alanine aminotransferase,ALT)均显著低于治疗前(P<0.05),白蛋白(albumin,Alb)显著高于治疗前(P<0.05);治疗后,研究组24-UCFP、ALT均显著低于对照组(P<0.05),Alb显著高于对照组(P<0.05)。治疗后,研究组HBV-DNA阳性的转阴率显著高于对照组(P<0.05)。结论乙型肝炎相关性IgA肾病给予丙酚替诺福韦联合吗替麦考酚酯治疗,临床疗效确切,对改善肝肾功能及控制HBV均具有较高应用价值。Objective To investigate the efficacy of tenofovir alafenamide combined with mycophenolate mofetil in the treatment of hepatitis B-related immunoglobulin(Ig)A nephropathy.Methods A total of 82 patients with hepatitis B-related IgA nephropathy admitted to our hospital from February 2016 to February 2020 were included for retrospective analysis of their medical records,and 41 patients treated with tenofovir alafenamide were set as controls group,41 patients treated with tenofovir alafenamide combined with mycophenolate mofetil were set as the study group.The clinical efficacy between the two groups were compared.The liver and kidney function and serum marker levels of hepatitis B virus (HBV) in the two groups before and after treatment were compared.Results The total effective rate in the study group was 95.12%,which was significantly higher than 78.05% in the control group(P<0.05).After treatment,the 24-hour urinary protein quantification (24-UCFP) and alanine aminotransferase (ALT) in the two groups were significantly lower than those before treatment (P<0.05),and albumin (Alb) was significantly higher than that before treatment (P<0.05).After treatment,24-UCFP and ALT in the study group were significantly lower than those in the control group (P<0.05),and Alb was significantly higher than that in the control group (P<0.05).After treatment,the negative rate of HBV-DNA positive in the study group was significantly higher than that in the control group (P<0.05).Conclusion Tenofovir alafenamide combined with mycophenolate mofetil in the treatment of hepatitis B-related IgA nephropathy has a definite clinical effect,and has high application value for the improvement of liver and kidney function and the control of HBV.

关 键 词：丙酚替诺福韦 肝肾功能 吗替麦考酚酯 免疫球蛋白A肾病 乙型肝炎病毒 

分 类 号：R692.31[医药卫生—泌尿科学]