阿德福韦酯治疗慢性乙型肝炎致低磷性骨软化症8例

Hypophosphatemic osteomalacia in 8 patients with adefovir dipivoxil treatment for patients with hepatitis B

目的进一步探讨阿德福韦酯(ADV)所致低磷性骨软化症的临床特点。方法回顾性分析2010至2012年共收治的8例慢性乙型肝炎患者经ADV治疗所致低磷性骨软化症的临床表现、治疗和转归。结果 8例患者均在服用ADV后出现低磷血症及骨质疏松,其主要临床表现为乏力、多发骨痛,进行加重至行走障碍;低血磷、低尿酸和高碱性磷酸酶血症、骨密度检查提示骨质疏松。经停用ADV、对症补钙、补磷治疗后患者的血磷恢复正常,疼痛缓解,骨质疏松改善。结论 ADV可引起低磷性骨软化症;补充磷、维生素D3及钙剂治疗可恢复。

Objective To investigate the clinical features of hypophosphatemic osteomalacia induced by adefovir dipivoxil treatment for patients with chronic hepatits B. Methods Total of 8 patients with hypophosphatemic osteomalaciachonic induced by adefovir dipivoxil treatment for chronic hepatits B from 2010 to 2012 admitted in our hospital were clinically analyzed. Results All patients occured hypophosphatemic osteomalacia after application of adefovir dipivoxil, with the main clinical manifestations as fatigue, multiple bone pain and progressive walking problems. Reduced serum phosphate level, low uric acid and high alkaline phosphatase hyperlipidemia, bone density examinations all showed osteoporosis. Hypophosphatemia was improved after discontinuation of adefovir dipivoxil and supplement with phosphorus and calcium. Conclusions Adefovir dipivoxil treatment could induce hypophosphatemic osteomalacia. Patients supplemented with vitamin D3 and calcium got cured.