富马酸丙酚替诺福韦对阿德福韦酯经治肾功能损伤慢乙肝患者疗效及肾功能影响观察  

Effect of Tenofovir Alafenamide Fumarate on Renal Function in Adefovir Dipivoxil-treated Patients with Chronic Hepatitis B Combing Renal Inpairment

作　　者：雷君 张少军 王黎黎 白志刚 邢铭友[2] Lei Jun;Zhang Shaojun;Wang Lili;Bai Zhigang;Xing Mingyou(Department of Infectious Disease,General Hospital of the Yangtze River Shipping,Wuhan 430010,China;Department of Infectious Disease,Tongji Hospital affiliated to Tongji Medical College of Huazhong University of Science&Techonology)

机构地区：[1]长江航运总医院感染科,武汉430010 [2]华中科技大学同济医学院附属同济医院感染科

出　　处：《药物流行病学杂志》2022年第10期666-668,699,共4页Chinese Journal of Pharmacoepidemiology

基　　金：武汉市卫生健康委科研资助项目(编号:WX18D25)。

摘　　要：目的:观察富马酸丙酚替诺福韦(TAF)对阿德福韦酯(ADV)经治慢性乙型肝炎(CHB)患者的抗病毒疗效及对肾功能的影响作用。方法:服用ADV治疗并出现轻度肾功能异常的CHB患者38例,换用TAF片(25 mg·d^(-1))抗病毒治疗,观察调整后的抗病毒疗效及患者肾功能指标变化。结果:调整前、调整治疗后24周及48周,所有患者的ALT水平均在正常范围内,未出现肝生化指标异常;HBV DNA均低于检测下限,未出现病毒反弹。调整治疗24周及48周,患者的SCr水平下降,肾小球滤过率(eGFR)升高,与调整前比较差异均有统计学意义(P<0.05)。结论:TAF可维持ADV经治出现轻度肾功能异常CHB患者的抗病毒效果,且换用后SCr水平及eGFR均有所改善。Objective:To study the antiviral effect and the renal function improvement of tenofovir disoproxil fumarate(TAF) on adefovir dipivoxil(ADV)-treated patients with chronic hepatitis B.Methods:38 patients with chronic hepatitis B who undergoing ADV treatment and manifesting renal function abnormality were giving therapy TAF 25 mg·d^(-1).The antiviral effect and the improvement of renal function were monitored before and after combination therapy.Results:The levels of alanine aminotransferase in all patients were in normal range whether before or 24 weeks and 48 weeks after combination therapy,with no biochemical abnormalities;the levels of HBV DNA were all lower than detection limit,with no viral rebound.After combination therapy for 24 weeks or 48 weeks,the patient’s serum creatinine level decreased,the estimated glomerular filtrationrate(eGFR) increased,showed statistical difference compared with that before combination therapy(P<0.05).Conclusion:TAF can maintain the antiviral effect of ADV in chronic hepatitis B patients with mild renal dysfunction,and the serum creatinine level and eGFR are improved after switching.

关 键 词：慢性乙型肝炎 富马酸丙酚替诺福韦 阿德福韦酯 肾功能异常 

分 类 号：R978.1[医药卫生—药品]