替比夫定引起神经肌肉病变的临床观察

Telbivudine-induced pathological changes in the peripheral nervous system and muscles

目的:观察替比夫定所致周围神经和肌肉病变的临床观察,并分析其与合并用药等因素的相关性。方法:对2007年8月～2008年10月我院应用替比夫定治疗慢性乙肝出现周围神经和肌病的患者进行观察,对合并用药、用法用量、实验室检查和患者病情等情况进行综合分析。结果:8例患者均为男性,年龄在25～50之间,其中2例患者合并应用干扰素,8例患者在出现肌肉病变的同时伴有CK水平的升高,其中有7例出现了周围神经系统异常,其中1例出现横纹肌溶解。结论:替比夫定可能会引起周围神经及肌肉病变,需引起医务人员和患者的广泛关注。

Objective： To observe the adverse effects of telbivudine in the peripheral nervous system and muscles, and analyze the related factors. Methods：We collected 8 patients with peripheral nervous system diseases and myopathy that related to telbivudine in our hospital from August 2007 to October 2008 ; analyzed the dosage of telbivudine, co-administrated drugs, the clinical manifestation of patients, and the results of laboratory tests. Resuits：All the 8 enrolled patients were male, and aged 25 - 50 years old. The patients received telbivudine 600 mg once daily; in two of them, telbivudine combined with intramuscular injection of interferon. Myopathy and elevated CK level were observed in all the 8 patients. Moreover, peripheral nervous system diseases occurred in 7 patients, and rhabdomyolysis in one patient. Conclusion：Telbivudine may cause peripheral nervous system diseases and myopathy, so medical staff and patients should pay extensive attention.