艾米替诺福韦治疗慢性乙型肝炎患者的临床效果  

Clinical efficacy of Tenofovir Amibufenamide in the treatment of patients with chronic hepatitis B

作　　者：周红燕 郭婷[1] 李清奇 易旭岚 王凤[4] 赖勤 ZHOU Hongyan;GUO Ting;LI Qingqi;YI Xulan;WANG Feng;LAI Qin(Department of Infectious Diseases,the Second Affiliated Hospital of Yichun University,Jiangxi Province,Yichun 336000,China;Department of Respiratory and Critical Care,the Second Affiliated Hospital of Yichun University,Jiangxi Province,Yichun 336000,China;Department of Internal Medicine,the Second Affiliated Hospital of Yichun University,Jiangxi Province,Yichun 336000,China;Department of Pediatrics,the Second Affiliated Hospital of Yichun University,Jiangxi Province,Yichun 336000,China;Department of Radiology,the Second Affiliated Hospital of Yichun,Jiangxi Province,Yichun 336000,China)

机构地区：[1]宜春学院第二附属医院感染科,江西宜春336000 [2]宜春学院第二附属医院呼吸与危重症科,江西宜春336000 [3]宜春学院第二附属医院内科,江西宜春336000 [4]宜春学院第二附属医院儿科,江西宜春336000 [5]宜春学院第二附属医院放射科,江西宜春336000

出　　处：《中国当代医药》2024年第15期24-27,共4页China Modern Medicine

基　　金：江西省卫生健康委科技计划项目(202140909)。

摘　　要：目的探讨艾米替诺福韦(TMF)治疗慢性乙型肝炎(CHB)患者的临床效果。方法选取2022年5月至10月江西省宜春学院第二附属医院收治的120例CHB患者为研究对象,按照患者治疗经历分为初治CHB组(n=38)与复治CHB组(n=82),均行TMF治疗。比较两组患者的病毒学应答情况,统计所有患者丙氨酸氨基转移酶(ALT)恢复正常比例,观察患者肌酐(Cr)、总胆固醇(TC)、甘油三酯(TG)、血清胱抑素C(CysC)、肾小球滤过率(eGFR)变化。结果两组患者在治疗12、24周后的乙型肝炎病毒核酸(HBV DNA)水平低于本组治疗前,初治CHB组治疗24周的完全病毒学应答比例高于本组治疗12周,差异有统计学意义(P<0.05)。复治CHB组在行TMF治疗前即已有40例实现完全病毒学应答,剩余42例患者治疗12、24周后的完全病毒学应答比例比较,差异无统计学意义(P>0.05)。所有患者治疗12周时ALT恢复正常比例为40.00%,治疗24周时ALT恢复正常比例为78.33%。所有患者治疗24周后的Cr、TC、TG、CysC、eGFR水平与治疗前比较,差异无统计学意义(P>0.05)。结论采用TMF治疗的CHB患者有良好的早期效果,患者肾功能及血脂指标无安全方面的不良影响,但长期效果依然有待观察。Objective To investigate the clinical effect of Tenofovir Amibufenamide(TMF)in the treatment of chronic hepatitis B(CHB).Methods A total of 120 CHB patients admitted to the Second Affiliated Hospital of Yichun University from May to October 2022 were selected as the study objects.According to their treatment experience,the patients were divided into initial CHB group(n=38)and retreated CHB group(n=82),and both groups were treated with TMF.The virological response of the two groups of patients was compared,and the proportion of alanine transaminase(ALT)returned to normal was counted in all patients,and the changes of creatinine(Cr),total cholesterol(TC),triglyceride(TG),serum cystatin C(CysC)and estimated glomerular filtration rate(eGFR)were observed.Results The hepatitis B virus DNA(HBV DNA)level of the two groups after 12 and 24 weeks of treatment was lower than those before treatment,and the proportion of complete virological response of the initial CHB group at 24 weeks of treatment was higher than that at 12 weeks of treatment,the differences were statistically significant(P<0.05).Complete virological response was achieved in 40 patients with retreated CHB before TMF treatment,and the proportion of complete virological response in the remaining 42 patients after 12 and 24 weeks of treatment was not statistically significant(P>0.05).The proportion of ALT returning to normal was 40.00%at 12 weeks and 78.33%at 24 weeks.There were no significant differences in the levels of Cr,TC,TG,CysC and eGFR of all patients after 24 weeks of treatment and before treatment(P>0.05).Conclusion TMF treatment of CHB patients has a good early effect,patients with renal function and lipid indexes have no adverse safety effects,but the long-term effect remains to be seen.

关 键 词：慢性乙型肝炎 艾米替诺福韦 抗病毒治疗 病毒应答 丙氨酸氨基转移酶 肾功能 

分 类 号：R512.62[医药卫生—内科学]