阿德福韦酯致低血磷性软骨症文献研究

Literature Analysis of Hypophosphatemic Cartilage Disease Induced by Adefovir Dipivoxil

目的探讨阿德福韦酯致低血磷性软骨病不良反应的规律及特点,为临床安全使用阿德福韦酯提供参考。方法以"阿德福韦酯"、"肾毒性"、"低血磷"、"不良反应"等为关键词检索2005～2012年4月中国期刊全文数据库(CNKI)文献,对文献中的有关数据进行统计分析。结果共检索到阿德福韦酯致肾损害和低血磷文献9篇,涉及病例共16例。阿德福韦酯致低血磷性软骨症,临床表现肾毒性为蛋白尿、血尿、肾小管功能受损等;低血磷累及的系统器官为骨骼、软骨、关节等;多为用药1.3～4年后出现。结论慢性肝炎患者需要长期服用阿德福韦酯,正常用法用量下也会出现肾毒性和低血磷。低血磷性软骨症临床少见,易被误诊,希望引起临床医师的警惕,以保障患者用药安全有效。

Objective To research the regularity and characteristics of hypophosphatemic osteomalacia induced by adefovir dipivoxil and provide references for drug safety in clinical use of adefovir dipivoxil.Methods The literature published during the year 2005to April 2012in Chinese Journal Full-text Database（CNKI） were searched taking ＂ adefovir dipivoxil ＂,＂ renal toxicity ＂,＂ low phosphorus ＂,＂ adverse reaction ＂,etc.as the key words,and the data in the literature was statistically analyzed.Results Totally there were 9articles about renal injury and hypophosphatemia induced by adefovir dipivoxil of 16cases.Adefovir dipivoxil could induce hypophosphatemic osteomalacia,whose clinical manifestations included renal toxicity of proteinuria,hematuria,renal function damage,involved organs such as bones,cartilages,joints and so on,which usually occurs in 1.3-4years after the medication.Conclusion Chronic hepatitis patients need long-term administration of adefovir dipivoxil which leads to renal toxicity and hypophosphatemia even at normal dosage.Hypophosphatemic osteomalacia is rare in clinic and easy to be misdiagnosed,which should arouse alert from the clinicians to ensure the safety and effectiveness of medication.