阿德福韦酯治疗慢性乙型肝炎的不良反应分析

Analysis of Adverse Reactions of Adefovir Dipivoxil in the Treatment of Chronic

目的研究阿德福韦酯治疗慢性乙型肝炎的不良反应。方法方便收集广东省兴宁市人民医院感染性疾病科2014年1月—2016年1月慢性乙型肝炎患者140例分两组,每组70例。拉米夫定组采用拉米夫定进行治疗;阿德福韦酯组采用阿德福韦酯治疗。就两组患者治疗前后肝功能有关指标的差异和慢性乙型肝炎治疗总有效率、药物不良反应发生率进行比较。结果阿德福韦酯组慢性乙型肝炎治疗总有效率88.57%稍微高于拉米夫定组85.71%,但组间差异无统计学意义(P>0.05)。仅有个别出现镜下血尿、一过性尿蛋白阳性、一过性尿素氮升高现象,所有患者无其他不良反应,淀粉酶、血肌酸激酶以及血常规等均正常,无出现血磷降低或血清肌酐上升现象,发生率均为2.86%。在治疗前两组患者肝功能有关指标相似,组间差异无统计学意义(P>0.05)。治疗后两组患者肝功能有关指标均显著改善,跟治疗前比较差异有统计学意义(P<0.05)。结论阿德福韦酯治疗慢性乙型肝炎的效果确切,可有效改善患者肝功能,但需注意监测血清肾功能和尿常规。

Objective To study the adverse effects of adefovir dipivoxil in the treatment of chronic hepatitis B.Methods A total of 140 patients with chronic hepatitis B were enrolled in the Department of Infectious Diseases,People's Hospital,Xingning City,Guangdong Province,from January 2014 to January 2016,70 patients in each group.Lamivudine was treated with lamivudine and the adefovir dipivoxil was treated with adefovir dipivoxil.The difference between the two groups of patients before and after treatment of liver function and chronic hepatitis B treatment of total effective rate,the incidence of adverse drug reactions were compared.Results The total effective rate of 88.57% in adefovir dipivoxil group was slightly higher than that in lamivudine group(85.71%),but there was no significant difference between the two groups(P>0.05).Only a slight microscopic hematuria,a transient proteinuria positive,a transient increase in urea nitrogen phenomenon,all patients without other adverse reactions,amylase,blood creatine kinase and blood routine were normal,no blood phosphorus decreased or serum creatinine increased,the incidence was 2.86%.There were no significant differences in liver function between the two groups before treatment,and there was no significant difference between the two groups(P>0.05).After treatment,the two groups of patients with liver function were significantly improved,with the treatment before the difference was significant(P<0.05).Conclusion Adefovir dipivoxil is effective in the treatment of chronic hepatitis B,which can effectively improve the liver function of patients,but it is necessary to pay attention to monitor serum renal function and urine routine.