TDF转换为TAF治疗病毒学应答后CHB的疗效和安全性研究

Study on the Efficacy and Safety of Conversion from TDF to TAF in the Treatment of CHB after Virological Response

目的:探究TAF治疗CHB患者的疗效及安全性。方法:回顾性分析某院2018年11月~2019年5月期间收治的132例TDF治疗48周以上,病毒已应答的慢性乙型肝炎患者,以续贯治疗药物的不同作为分组依据,将继续使用TDF的患者纳入对照组,TDF转换为TAF的患者纳入实验组各66例,记录两组治疗基线时间及48周后临床数据并进行分析。结果:两组在基线上,ALT、AST、Cr、UA、β2-MG、CHOL、TG、LDL-C、FS无统计学差异,实验组Uβ2-MG(1.21±0.149 mg/L)明显高于对照组(0.46±0.057 mg/L),且具有统计学意义(P<0.001);两组在48周时,ALT、AST、Cr、UA、β2-MG、Uβ2-MG、TG、FS无统计学差异,实验组CHOL、LDL-C(4.88±0.719、2.90±0.578)明显高于对照组(4.41±0.696、2.70±0.389),且均具有统计学意义(P<0.05)。两组均未出现病毒学突破表现。结论:对于TDF经治的CHB患者,换用TAF的疗效不劣于TDF持续治疗,在肾小管安全性上具有优势,但需注意血脂异常。

Objective:To explore the efficacy and safety of TAF in the treatment of patients with CHB.Methods:A total of 132 patients with chronic hepatitis B who had been treated with TDF for more than 48 weeks from November 2018 to May 2019 were retrospectively analyzed.According to the different drugs of continuous treatment,66 patients who continued to use TDF were included in the control group,and 66 patients who were converted from TDF to TAF were included in the experimental group.The clinical data of the baseline time and 48 weeks after treatment in the two groups were recorded and analyzed.Results:At baseline,there was no significant difference in ALT,AST,Cr,UA,β2-MG,CHOL,TG,LDL-C and FS between the two groups.Uβ2-MG in the experimental group(1.21±0.149 mg/L)was significantly higher than that in the control group(0.46±0.057 mg/L),with statistical significance(P<0.001).At 48 weeks,there was no significant difference in ALT,AST,Cr,UA,β2-MG,Uβ2-MG,TG and FS between the two groups.CHOL and LDL-C in the experimental group(4.88±0.719,2.90±0.578)were significantly higher than those in the control group(4.41±0.696,2.70±0.389),with statistical significance(P<0.05).There was no virological breakthrough in both groups.Conclusion:For the CHB patients treated with TDF,the curative effect of switching to TAF is not inferior to that of TDF continuous treatment,and it has an advantage in the safety of renal tubules,but attention should be paid to dyslipidemia.