替比夫定联合阿德福韦酯治疗失代偿期乙型肝炎肝硬化患者疗效及其对肾功能的影响*

doi:10.3969/j.issn.1672-5069.2019.01.024

实用肝脏病杂志 ›› 2019, Vol. 22 ›› Issue (1): 89-92.doi: 10.3969/j.issn.1672-5069.2019.01.024

替比夫定联合阿德福韦酯治疗失代偿期乙型肝炎肝硬化患者疗效及其对肾功能的影响^*

徐静, 陶琳琳, 叶娇娇, 张蕊, 王加加, 袁莉莉, 赵俊奖

230001 合肥市中国科学技术大学附属第一医院/安徽省立医院感染病科(徐静); 感染病医院感染性疾病病区（陶琳琳,叶娇娇,张蕊,王加加,袁莉莉,赵俊奖）

收稿日期:2018-01-03 出版日期:2019-01-10 发布日期:2019-01-16
作者简介:徐静,女,45岁,医学硕士,副主任医师。从事感染性疾病的诊断和治疗学研究。E-mail:xj3979@163.com
基金资助:
*安徽省公益性研究联动计划项目（编号:15011d04029）

Impact of terbivudine combined with adefovir dipivoxil therapy on renal functions in patients with decompensated hepatitis B liver cirrhosis

Xu Jing, Tao Linlin, Ye Jiaojiao, et al.

Department of Infectious Diseases,Provincial Hospital,Affiliated to University of Science and Technology of China,Hefei 230001,Anhui Province,China

Received:2018-01-03 Online:2019-01-10 Published:2019-01-16

摘要/Abstract

摘要： 目的以应用拉米夫定（LAM）联合阿德福韦酯（ADV）治疗为对照,探讨替比夫定（LdT）联合阿德福韦酯（ADV）治疗对ADV耐药的失代偿期乙型肝炎肝硬化患者的疗效及其对肾功能的影响。方法在纳入的76例失代偿期乙型肝炎肝硬化期患者中,39例观察组接受LdT 联合ADV治疗,37例对照组接受LAM联合ADV治疗,观察52 w。采用简化的肾脏病饮食改良公式计算估算的肾小球滤过率（eGFR）,计量资料采用t检验,计数资料采用x²检验。结果在治疗52 w时,两组患者血清ALT、ALB、TBIL 、Child-Push评分和HBV DNA阴转率比较,差异无统计学意义（P>0.05）; 观察组eGFR为（118.5±14.2） ml·min^-1·1.73 m^-2,显著高于对照组[（94.2±18.5） ml·min^-1·1.73 m^-2,P<0.05],观察组血清Cr水平为（70.5±8.8） μmol/L,显著低于对照组[（109.1±15.8）μmol/L,P<0.05]。结论 LdT联合ADV治疗失代偿期乙型肝炎肝硬化患者疗效显著,同时可改善患者肾功能。

关键词: 肝硬化, 乙型肝炎, 替比夫定, 拉米夫定, 阿德福韦酯, 肾小球滤过率, 治疗

Abstract: Objective To evaluate the impact of terbivudine （LdT） combined with adefovir dipivoxil （ADV） therapy on renal functions in patients with decompensated hepatitis B liver cirrhosis. Methods In this cohort study,76 patients with HBV-induced decompensated liver cirrhosis were divided into two groups,and 39 cases in observation group received combination of LdT and ADV,and 37 cases in control group received lamivudine（LAM） and ADV therapy. All the patients were followed-up for 52 weeks. The estimated glomerular filtration rate（eGFR） were calculated as reported in literature. Results At the end of 52th week,serum ALT, ALB and TBIL levels,Child-Pugh scores and HBV DNA negative rates in the two groups were significantly improved as compared with those before treatment （P<0.05） and no significant differences between the two groups （P>0.05）;the eGFR in observation group was（118.5±14.2） ml.min-1.1.73 m^-2,significantly higher than that in the control group[（94.2±18.5） ml·min^-1·1.73 m^-2,P<0.05],and serum creatinine level in observation group was （70.5±8.8） μmol/L,significantly lower than that in the control group[（109.1±15.8） μmol/L,P<0.05]. Conclusion The combination of LdT and ADV therapy in dealing with ADV-resistance has a good efficacy in patients with HBV-induced decompensated liver cirrhosis,which needs further observation.

Key words: Liver cirrhosis, Hepatitis B, Telbivudine, Lamivudine, Adefovir dipivoxil, Estimated glomerular filtration rate, Therapy

徐静, 陶琳琳, 叶娇娇, 张蕊, 王加加, 袁莉莉, 赵俊奖. 替比夫定联合阿德福韦酯治疗失代偿期乙型肝炎肝硬化患者疗效及其对肾功能的影响^*[J]. 实用肝脏病杂志, 2019, 22(1): 89-92.

Xu Jing, Tao Linlin, Ye Jiaojiao, et al.. Impact of terbivudine combined with adefovir dipivoxil therapy on renal functions in patients with decompensated hepatitis B liver cirrhosis[J]. JOURNAL OF PRACTICAL HEPATOLOGY, 2019, 22(1): 89-92.

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替比夫定联合阿德福韦酯治疗失代偿期乙型肝炎肝硬化患者疗效及其对肾功能的影响^*

Impact of terbivudine combined with adefovir dipivoxil therapy on renal functions in patients with decompensated hepatitis B liver cirrhosis

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