替比夫定治疗慢性乙型肝炎96周对肾脏功能的影响

Influence of 96-week telbivudine therapy on renal function in patients with chronic hepatitis B

目的：研究替比夫定治疗慢性乙型肝炎患者对肾脏功能的影响。方法回顾性分析替比夫定治疗42例慢性乙型肝炎患者,比较治疗96周前后血清肌酐（ CR）,估算肾小球滤过率（ eGFR）较基线的变化情况及eGFR≥90ml/（min·1.73m2）患者的比例。结果96周各随访点,患者 CR、eGFR 差异无显著性（P〉0.05）。96周时,患者CR、eGFR较基线变化平均值为-1.6μmol/L、4.4ml/（min·1.73m2）。基线肾功能轻度受损[eGFR60~90 ml/（min·1.73m2）]的患者中,38.1%（8/21）患者上升至〉90ml/（min·1.73m2）,治疗96周时eGFR较基线差异有显著性（P=0.04）。 eGFR≥90ml/（min·1.73m2）患者比例由基线的50%升至96周的59.5%（P=0.381）。结论对于基线肾功能受损的患者[eGFR 60~90 ml/（min·1.73m2）],使用替比夫定抗病毒治疗,其肾功能可得到一定程度的改善。

Objective To evaluate the influence of telbivudine （ L-DT） on the renal function of patients with chronic hepatitis B （ CHB） . Method This retrospective analysis involved 42 patients with CHB receiving telbivudine mono-therapy for 96 weeks. Serum creatinine, estimates of glomerular filtration rate （ eGFR） , and the percentage of pa-tients with eGFR≥90 ml/（min·1. 73m2） at week 96 were compared with the baseline data. Result There were no significant differences in CR and eGFR during the 96-week follow-ups, respectively. The mean change of CR and eGFRatweek96frombaselinewere -1.6μmol/Land4.4ml/（min·1.73m2）,respectively.Thirtyeightpercent （8/21） of the patients with baseline eGFR 60~90 ml/（min·1. 73m2） shifted to eGFR≥90 ml/（min·1. 73m2） after 96 weeks of L-DT treatment, and eGFR at week 96 increased significantly than the baseline（P=0. 04）. The proportion of patients with eGFR≥90 ml/（min·1. 73m2） in L-DT group increased from 50% （21/42） at baseline to 59. 5% （25/42） at week 96. Conclusion L-DT treatment has good impact on renal function of CHB patients with mild renal dysfunction[eGFR60~90 ml/（min·1. 73m2）].