核苷(酸)类似物对慢性乙型病毒性肝炎患者肾小球滤过率的影响

Impact of nucleoside analogues on glomerular filtration rate in patients with chronic hepatitis B

目的比较核苷(酸)类似物抗病毒治疗前后对肾小球滤过率的影响,分析可能的影响因素。方法以慢性乙型肝炎患者为研究对象,分为恩替卡韦治疗组(0.5 mg/d)、阿德福韦酯治疗组(10 mg/d)和替比夫定治疗组(600 mg/d)。观察抗病毒治疗52周后各组肾小球滤过率(GFR)的变化,并进行3组患者治疗前后HBeAg血清学转换率、GFR升高≥10 mL/(min.1.73 m2)及治疗后GFR≥90 mL/(min.1.73 m2)的比较,以及出现HBeAg血清学转换患者治疗前后GFR的比较。结果替比夫定组在治疗52周后GFR升高(P<0.05);治疗前后GFR升高≥10 mL/(min.1.73 m2)的患者比例替比夫定组优于阿德福韦酯组(P<0.05)。结论替比夫定抗病毒治疗后慢性乙型肝炎患者GFR得到改善。

Objective To examine the changes of glomerular filtration rate（GFR） in chronic hepatitis B（CHB） patients treated with Nucleoside Analogues（NAs）,and to analysis potential influence factors.Methods CHB patients were divided into adefovir（ADV,10 mg/d） group,entecavir（ETV,0.5 mg/d） group,telbivudine（LDT,600 mg/d） group.We compared the changes of GFR in CHB patients with antivirus therapy over 52 weeks among three groups,and compared the changes of HBeAg serological conversion rate,GFR increased ≥10 mL/（min·1.73 m^2）,GFR≥90 mL/（min·1.73 m^2） after treatment,and investigated the GFR in patients with HBeAg serological conversion.Results The GFR was improved in patients treated with LDT（P〈0.05）.The number of patients treated with LDT were higher compared with ADV about GFR increased ≥10 mL/（min·1.73 m^2）（P〈0.05）.Conclusion The GFR in CHB patients were improved after LDT therapy,which provided a new idea for future antivirus therapy.