替诺福韦治疗艾滋病导致范可尼综合征的影响因素及预后效果分析

To analyze the factors influencing the treatment of Fanconi syndrome caused by AIDS and the prognosis of Tenofovr

目的 探讨替诺福韦(TDF)治疗艾滋病导致范可尼综合征的影响因素和预后效果。方法 随机抽选东莞市第九人民医院2019年9月-2020年9月接收的40例替诺福韦治疗艾滋病导致的范可尼综合征患者,对其影响因素和预后效果进行综合分析。结果 替诺福韦治疗艾滋病导致的范可尼综合征临床表现以电解质紊乱及其引起的代谢性酸中毒和肾小管功能变化为主,其中肌酐升高占比为52.50%:轻度10例、中度7例、重度4例;合并骨质疏松患者15例,占比为37.50%。40例患者中,合并基础疾病患者37例,占比92.50%,其中有23例合并2种基础疾病,占比57.50%;12例合并3种基础疾病,占比30.00%;2例合并4种基础疾病,占比5.00%。经治疗后,有7例肌酐、电解质、尿蛋白未缓解,2例病情加重,占比分别为17.50%,5.00%。结论 采用替诺福韦治疗艾滋病过程中,需要定期对患者电解质、肾功能和尿常规等进行监测,一旦发现范可尼综合征,需要及时实施治疗,以改善患者预后。

Objective To explore the influence factors and prognosis of tenofovir(TDF)in the treatment of Fanconi syndrome caused by AIDS.Methods 40 patients with Fanconi syndrome caused by AIDS in our hospital from September 2019to September 2020 were randomly selected. All patients were treated with tenofovir. The influencing factors and prognosis were analyzed comprehensively.Results The main clinical manifestations of Fanconi syndrome caused by AIDS were electrolyte disorder,metabolic acidosis and renal tubular function changes,in which the increase of creatinine accounted for 52.50%;10cases were mild,7 cases were moderate,and 4 cases were severe;15 cases were complicated with osteoporosis,accounting for37.50%.Among the 40 patients,37 cases were combined with basic diseases,accounting for 92.50%,including 23 cases with 2kinds of basic diseases,accounting for 57.50%;12 cases with 3 kinds of basic diseases,accounting for 30.00%;2 cases with 4kinds of basic diseases,accounting for 5.00%.After treatment,7 cases had no remission of creatinine,electrolytes and urinary protein,and 2 cases were aggravated,accounting for 17.50% and 5.00% respectively.Conclusion During the course of tenofovir treatment,it is necessary to monitor the electrolyte,renal function and urine routine of patients regularly. Once Fanconi syndrome is found,treatment should be carried out in time in order to obtain ideal therapeutic effect.