中老年慢性乙型肝炎50例采用富马酸替诺福韦酯治疗后的肾功能变化  

The Effect of Tenofovir Disoproxil Fumarate on Early Renal Damage in 50 Cases of Patients with Chronic Hepatitis B

作　　者：林学[1] 戴颖[1] 陈川英[1] 魏玲[1] LIN Xue;DAI Ying;CHEN Chuanying;WEI Ling(Nanchang Ninth Hospital,Nanchang Jiangxi 330002,China)

机构地区：[1]南昌市第九医院,江西南昌330002

出　　处：《药品评价》2023年第10期1242-1245,共4页Drug Evaluation

基　　金：江西省卫生健康委科技计划(202140124)。

摘　　要：目的探讨中老年慢性乙型肝炎患者服用富马酸替诺福韦酯后对早期肾功能的影响。方法选取2021年1月至3月南昌市第九医院收治的50例年龄大于50岁使用富马酸替诺福韦酯治疗的慢性乙型肝炎患者(研究组)和50例年龄大于50岁健康人(对照组)为研究对象,随访96周。检测两组患者入组前及随访过程中肝功能、乙型肝炎病毒脱氧核糖核酸(HBV-DNA)、血清肌酐、血清胱抑素C、血清视黄醇结合蛋白、尿微量白蛋白变化。结果研究组治疗48周后,HBV-DNA均低于检测下限,血清谷丙转氨酶复常率为70%。入组时(0周),两组血清肌酐、血清胱抑素C、血清视黄醇结合蛋白、尿微量白蛋白差异无统计学意义(P>0.05);组内比较时,研究组血清肌酐24周、48周、72周、96周与0周时比较,差异无统计学意义(P>0.05);研究组血清胱抑素C、尿微量白蛋白24周、48周与0周时比较,差异无统计学意义(P>0.05),72周、96周时,研究组血清胱抑素C值、尿微量白蛋白均高于0周,差异有统计学意义(P<0.05);研究组血清视黄醇结合蛋白值24周、48周、72周与0周比较,差异无统计学意义(P>0.05),96周时,研究组血清视黄醇结合蛋白值高于0周,差异有统计学意义(P<0.05);对照组血清肌酐、血清胱抑素C、血清视黄醇结合蛋白、尿微量白蛋白24周、48周、72周、96周与0周时比较,差异无统计学意义(P>0.05)。结论中老年慢性乙型肝炎患者使用富马酸替诺福韦酯抗病毒治疗,疗效确切,但存在早期肾功能损害风险。Objective To investigate the effect of tenofovir disoproxil fumarate on early renal damage in patients with chronic hepatitis B.Methods 50 healthy people older than 50 years old(control group)and 50 chronic hepatitis B patients older than 50 years old(study group)who were from were Nanchang Ninth Hospital between January 2021 and March 2021 were enrolled.The follow-up period was 96 weeks.The changes of liver function,HBV-DNA,serum creatinine,serum cystatin C,serum retinol-binding protein and urinary microprotein were detected before and during the follow-up.Results In the study group,after 48 weeks of antiviral treatment with tenofovir disoproxil fumarate,the HBV-DNA value was lower than the detection limit,and the recovery rate of serum alanine aminotransferase was 70%.At baseline(0 week),there were no significant differences in serum creatinine,serum cystatin C,serum retinol-binding protein,and urinary microprotein between the two groups(P>0.05).In the study group,for intra-group comparisons,there was no significant difference in serum creatinine at 24,48,72,96 weeks compared with 0 week(P>0.05);in the study group,serum cystatin C,urinary microprotein of 24 weeks and 48 weeks compared with 0 weeks,no statistical difference(P>0.05),at 72 weeks and 96 weeks,the values of the serum cystatin C and urinary protein were higher than 0 week,the difference was statistically significant(P<0.05);serum retinol-binding protein value of 24 weeks,48 weeks and 72 weeks compared with 0 weeks,no statistical difference(P>0.05),at 96 weeks,the serum retinol-binding protein value was higher than 0 week,the difference was statistically significant(P<0.05).In the control group,there were no significant differences in serum creatinine,serum cystatin C,serum retinol-binding protein,and urinary microprotein at 24,48,72,and 96 weeks compared with 0 week(P>0.05).Conclusion This study shows that antiviral therapy with tenofovir disoproxil fumarate is effective,but there may be a risk of early renal function damage,which should be paid atte

关 键 词：乙型肝炎 慢性 替诺福韦 视黄醇结合蛋白 胱抑素C 安全性 肾功能不全 不良反应 

分 类 号：R512.62[医药卫生—内科学]