替比夫定对慢性乙型肝炎合并糖尿病患者血清钙的影响

Effect of telbivudine for serum calcium in patients with chronic diabetes

目的探讨慢性乙型肝炎合并2型糖尿病患者经替比夫定治疗后对血清钙(Ca)水平的影响。方法依据入组标准,将入组患者分为慢性乙型肝炎合并2型糖尿病组(CHB+DM组)35例、慢性乙型肝炎组(CHB组)48例、2型糖尿病组(DM组)32例、正常对照组30例。分别检测各组患者血清Ca水平,同时所有慢性乙型肝炎患者83例,均给予替比夫定600 mg/d口服,观察应用替比夫定治疗12周前后患者血清Ca水平的变化。结果正常对照组分别与CHB+DM组、CHB组、DM组血清Ca水平进行比较,正常对照组血清Ca水平偏高,差异有统计学意义(t分别为5.021、5.869、6.004,P<0.05);CHB+DM组与CHB组在替比夫定治疗前,2组患者血清Ca水平差异无统计学意义(t=0.735,P>0.05),经替比夫定治疗12周后,2组患者血清Ca水平均较治疗前有所升高,其中CHB+DM组血清Ca水平升高明显,与治疗前相比差异有统计学意义(t=5.274,P<0.05);分析CHB+DM组患者血清Ca水平与各项肝功能指标的相关性,血清Ca与血清白蛋白(ALB)呈正相关性(r=0.428,P<0.05)。结论替比夫定治疗慢性乙型肝炎合并2型糖尿病患者过程中,可能具备一定的改善肾脏对钙离子的重吸收功能,但具体机制尚未明确,有待进一步深入研究。

Objective To discussion the effect of telbivudine on serum calcium levels in chronic hepatitis B patients with diabe- tes mellitus. Methods Based on the criteria, patients were divided into chronic hepatitis B patients with diabetes group （ CHB ＆ DM group） ,chronic hepatitis B （CHB group） ,diabetic group （DM group） and control group. All the patients were measured the serum calcium （Ca） level. All eases of chronic hepatitis B patients were given telbivudine （LDT） 600mg/d orally,The changes of calcium levels in serum were observed before and after treatment with telbivudinel2 weeks. Results Compared withthe CHB ＆ DM group, CHB group and DM group respectively, the serum Ca levels were statistically higher in thenormal group （ t = 5.021,5. 869,6. 004, P 〈 0.05 ） ; Before tel- bivudine treatment for CHB ＆ DM group and CHB group, there were no statistically difference in serum Ca level between the two groups （ t = 0. 735,P 〉 0.05 ）. After telbivudine treatment for 12 weeks, the serum Ca level in the two groups were all increased, the serum Ca levels in CHB ＆ DM groupincreased significantly（ t = 5. 274 ,P 〈 0.05 ）. Analysis of the correlation between serum calcium levels in pa- tients of CHB ＆ DM group and the liver function, the level of calcium and albumin （ ALB ） in serum were positively correlated （ r = 0.428 ,P 〈 0.05 ）. Conclusion Telbivudine treatment of chronic hepatitis B patients with diabetes may simultaneously improve renal calcium reabsorption, but the exact mechanism is unclear and require of further research.