核苷(酸)类药物联合激素治疗慢性HBV感染合并肾病综合征的疗效观察

Clinical efficacy of nucleoside (acid) drugs combined with glucocorticoid in treatment of chronic HBV infection complicated with nephrotic syndrome

目的探讨核苷(酸)类抗病毒药物联合激素治疗慢性HBV感染合并肾病综合征(NS)的临床疗效。方法 18例慢性HBV感染合并NS患者随机分为三组:慢性活动性乙肝组(A组)、慢性HBV携带者组(B组)和非活动性HBV携带者组(C组),均予激素治疗,前两组联用抗病毒药物,而C组未联用,观察24 h尿蛋白定量、肝功能及HBVDNA水平。结果所有患者尿蛋白均有所下降,前两组的HBV DNA载量有所下降,而C组则有部分出现HBV的再激活并伴不同程度的肝损。结论慢性HBV感染合并NS在接受激素治疗时,应及时予以规范的抗病毒治疗,可有效避免激素引起的乙肝病毒再激活。

Objective To explore the clinical efficacy of nucleoside （acid） drugs combined with glucocorticoid in treatment of chronic hepatitis B virus infection complicated with nephrotic syndrome. Methods Eighteen patients with HBV infection complicated with nephrotic syndrome were treated by glucocorticoid, parts of them were also treated by nucleoside （acid） drugs. The 24-hour urinary protein, liver function and HBV DNA level were observed. Results After the treatment of glu- eoeorticoid, all the urinary protein were decreased. The HBV DNA levels of the groups together with the treatment of nu- cleoside （acid） drugs were reduced while the HBV DNA of the third group was broken through and with varying degrees of liver damage. Conclusion Antiviral therapy should be adopted when chronic HBV infection complicated with nephrotic syndrome receiving hormone therapy, which can effectively avoid the HBV reactivation caused by hormone.