长期恩替卡韦抗病毒治疗对老年慢性乙型肝炎患者肾脏功能的影响

Impact of long-term antiviral therapy with Entecavir on renal function in elderly patients with chronic hepatitis B

目的评价恩替卡韦(ETV)长期治疗对老年慢性乙型肝炎(CHB)患者肾功能的影响。方法回顾性分析北京友谊医院经ETV(0.5 mg/d)抗病毒治疗并随访达234周的老年CHB患者,应用估算肾小球滤过率(eGFR)(CKD-EPI肌酐公式)评价基线、治疗52周、104周、156周、208周和234周的肾功能变化。结果共入组40例CHB患者,年龄60~81岁,40例患者基线eGFR值为(64.25±11.32)ml·min^-1·1.73 m^-2,ETV治疗52周(40例)、104周(40例)、156周(38例)、208周(36例)、234周(28例)eGFR值分别为(63.85±11.53)ml·min^-1·1.73 m^-2、(63.71±11.58)ml·min^-1·1.73 m^-2、(59.95±9.59)ml·min^-1·1.73 m^-2、(62.28±15.32)ml·min^-1·1.73 m^-2、(65.78±15.99)ml·min^-1·1.73 m^-2,各时间点eGFR值比较差异无统计学意义(F=0.291、P=0.072),且两两比较结果显示,ETV治疗后各观察时间点eGFR值与基线值比较,差异均无统计学意义(均P>0.05)。40例患者基线肌酐值均数为(57.23±9.67)μmol/L,,ETV治疗52周(15例)、104周(5例)、156周(6例)、208周(8例)、234周(6例)肌酐值分别为(63.78±8.63)μmol/L、(67.86±11.21)μmol/L、(71.46±13.75)μmol/L、(68.22±8.99)μmol/L、(79.53±9.58)μmol/L,各时间点肌酐值比较差异无统计学意义(F=0.266、P=0.067),且两两比较结果显示,ETV治疗后各观察时间点肌酐值与基线值比较,差异均无统计学意义(均P>0.05)。结论ETV治疗对老年患者的肾功能无影响。

Objective To evaluate the impact of long-term treatment with Entecavir(ETV)on renal function in elderly patients with chronic hepatitis B(CHB).Methods Elderly patients with CHB receiving ETV(0.5 mg/d)antiviral therapy who were followed up for 234 weeks in Beijing Friendship Hospital were retrospective analyzed.The estimated glomerular filtration rate(eGFR)(CKD-EPI creatinine formula)was used to evaluate renal function changes at baseline and 52,104,156,208 and 234 weeks after treatment.Results A total of 40 included patients with CHB aged 60-81 years were enrolled,with baseline eGFR value(n=40)of(64.25±11.32)ml·min^-1·1.73 m^-2.The eGFR values at all time points after treatment were as following:(63.85±11.53)ml·min^-1·1.73 m^-2,(63.71±11.58)ml·min^-1·1.73 m^-2,(59.95±9.59)ml·min^-1·1.73 m^-2,(62.28±15.32)ml·min^-1·1.73 m^-2,(65.78±15.99)ml·min^-1·1.73 m^-2 at 52 weeks(40 cases),104 weeks(40 cases),156 weeks(38 cases),208 weeks(36 cases)and 234 weeks(28 cases)after ETV treatment respectively.And the difference of eGFR values among all time points was not statistically significant(F=0.291,P=0.072).The results of the pairwise comparison showed that as compared with the baseline eGFR value,the eGFR values had no statistically significant difference at all time points after treatment(P>0.05).The baseline creatinine value in all 40 patients was(57.23±9.67)μmol/L.Creatinine values at 52 weeks(15 cases),104 weeks(5 cases),156 weeks(6 cases),208 weeks(8 cases)and 234 weeks(6 cases)after ETV treatment,were(63.78±8.63)μmol/L,(67.86±11.21)μmol/L,(71.46±13.75)μmol/L,(68.22±8.99)μmol/L and(79.53±9.58)μmol/L respectively,with no significant difference(F=0.266,P=0.067).The results of the pairwise comparison showed that as compared with the baseline creatinine value,the creatinine values had no significant difference at all time points after ETV treatment(P>0.05).Conclusions ETV treatment has no effect on renal function in elderly patients with chronic hepatitis B.