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Improvement of hepatic fibrosis after tenofovir disoproxil fumarate switching to tenofovir alafenamide for three years
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作者 Tung Huynh Delana MyAn Bui +1 位作者 Tina Xiwen Zhou Ke-Qin Hu 《World Journal of Hepatology》 2024年第7期1009-1017,共9页
BACKGROUND Both tenofovir alafenamide(TAF)and tenofovir disoproxil fumarate(TDF)are the first-line treatments for chronic hepatitis B(CHB).We have showed switching from TDF to TAF for 96 weeks resulted in further alan... BACKGROUND Both tenofovir alafenamide(TAF)and tenofovir disoproxil fumarate(TDF)are the first-line treatments for chronic hepatitis B(CHB).We have showed switching from TDF to TAF for 96 weeks resulted in further alanine aminotransferase(ALT)improvement,but data remain lacking on the long-term benefits of TDF switching to TAF on hepatic fibrosis.AIM To assess the benefits of TDF switching to TAF for 3 years on ALT,aspartate aminotransferase(AST),and hepatic fibrosis improvement in patients with CHB.METHODS A single center retrospective study on 53 patients with CHB who were initially treated with TDF,then switched to TAF to determine dynamic patterns of ALT,AST,AST to platelet ratio index(APRI),fibrosis-4(FIB-4)scores,and shear wave elastography(SWE)reading improvement at switching week 144,and the associated factors.RESULTS The mean age was 55(28-80);45.3%,males;15.1%,clinical cirrhosis;mean baseline ALT,24.8;AST,25.7 U/L;APRI,0.37;and FIB-4,1.66.After 144 weeks TDF switching to TAF,mean ALT and AST were reduced to 19.7 and 21,respectively.From baseline to switching week 144,the rates of ALT and AST<35(male)/25(female)and<30(male)/19(female)were persistently increased;hepatic fibrosis was also improved by APRI<0.5,from 79.2%to 96.2%;FIB-4<1.45,from 52.8%to 58.5%,respectively;mean APRI was reduced to 0.27;FIB-4,to 1.38;and mean SWE reading,from 7.05 to 6.30 kPa after a mean of 109 weeks switching.The renal function was stable and the frequency of patients with glomerular filtration rate>60 mL/min was increased from 86.5%at baseline to 88.2%at switching week 144.CONCLUSION Our data confirmed that switching from TDF to TAF for 3 years results in not only persistent ALT/AST improvement,but also hepatic fibrosis improvement by APRI,FIB-4 scores,as well as SWE reading,the important clinical benefits of long-term hepatitis B virus antiviral treatment with TAF. 展开更多
关键词 tenofovir alafenamide tenofovir disoproxil fumarate SWITCHING Hepatic fibrosis improvement Aspartate aminotransferase to platelet ratio index Fibrosis-4 Shear wave elastography
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Tenofovir disoproxil fumarate in Chinese chronic hepatitis B patients:Results of a multicenter,double-blind,double-dummy,clinical trial at 96 weeks 被引量:1
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作者 Xiao-Fan Chen Ya-Nan Fan +18 位作者 Chong-Wen Si Yan-Yan Yu Jia Shang Zu-Jiang Yu Qing Mao Qing Xie Wei Zhao Jun Li Zhi-Liang Gao Shan-Ming Wu Hong Tang Jun Cheng Xin-Yue Chen Wen-Hong Zhang Hao Wang Zhong-Nan Xu Ling Wang Jun Dai Jing-Hang Xu 《World Journal of Clinical Cases》 SCIE 2021年第18期4690-4699,共10页
BACKGROUND Tenofovir disoproxil fumarate(TDF)is a prodrug of a nucleotide analogue.As an antiviral drug,TDF has been proposed in the first-line treatment of chronic hepatitis B(CHB).Qingzhong,a brand name of TDF,comme... BACKGROUND Tenofovir disoproxil fumarate(TDF)is a prodrug of a nucleotide analogue.As an antiviral drug,TDF has been proposed in the first-line treatment of chronic hepatitis B(CHB).Qingzhong,a brand name of TDF,commercialized by Jiangsu Chia-tai Tianqing Pharmaceutical Co Ltd.,and Viread,another brand name of TDF,commercialized by GlaxoSmithKline,have both been approved by the State Food and Drug Administration,China.AIM To investigate the efficacy and safety of the two TDF agents in the treatment of Chinese CHB patients.METHODS This trial was registered at ClinicalTrials.gov with the identifier number of NCT02287857.A total of 330 Chinese CHB patients,among which 232 were hepatitis B e antigen(HBeAg)-positive,were included in this 5-year-long,multicenter,double-blinded,double-dummy,randomized-controlled,noninferiority phase III trial.The participants were initially randomized into two groups:Group A(n=161),in which the participants received 300 mg Qingzhong once a day for 48 wk;and Group B,in which the participants received 300 mg Viread once a day for 48 wk.Starting from week 49,all the participants in Groups A and B received 300 mg Qingzhong once a day until the 96th week.In this study,the primary endpoint was the decrease in plasma level of hepatitis B virus(HBV)DNA at the 96th week,while the secondary endpoints were suppression of HBV replication,alanine aminotransferase(ALT)normalization,HBeAg loss,and HBeAg seroconversion rates.RESULTS For the participants with HBeAg-positive CHB,the decrease in mean HBV DNA level relative to the baseline value was comparable between Groups A and B(5.77 vs 5.73 log10 IU/mL,P>0.05)at the 96th week.In addition,similar percentages of HBeAg-positive participants in the two groups exhibited undetectable levels of HBV DNA,HBeAg loss,and HBeAg seroconversion(71.05%vs 77.97%,31.00%vs 27.27%,and 20.22%vs 15.79%,respectively,in Group A vs Group B;P>0.05).For the participants with HBeAg-negative CHB,the decrease in mean HBV DNA level relative to the baseline value was also comparable between Groups A and B(4.46 vs 4.70 log10 IU/mL,P>0.05)at the 96th week.In addition,similar percentages of HBeAg-negative participants in the two groups exhibited undetectable levels of HBV DNA(87.23%vs 94.12%in Group A vs Group B,respectively;P>0.05).Finally,similar percentages of CHB patients(HBeAg-positive or HBeAg-negative)in the two groups exhibited normalization of ALT(80.14%vs 84.57%in Group A vs Group B,respectively;P>0.05),and similar incidences of adverse events were observed(106 vs 104 in Group A vs Group B,respectively;P>0.05).CONCLUSION Both Qingzhong and Viread are effective and safe in the treatment of Chinese CHB patients according to the results of our clinical trial. 展开更多
关键词 Chronic hepatitis B Hepatitis B virus infection CHRONIC tenofovir disoproxil
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Treatment of Chronic Hepatitis B with Tenofovir Disoproxil Fumarate in Ivory Coast
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作者 Ya Henriette Kissi Anzouan-Kacou Adjeka Stanislas Doffou +7 位作者 Djeinabou Diallo Demba Aboubacar Bangoura Yacouba Adéhouni Hatrydt Dimitri Kouamé Alassan Kouamé Mahassadi Fulgence Yao Bathaix Koffi Alain Attia Aya Thérèse Ndri-Yoman 《Open Journal of Gastroenterology》 2016年第2期39-45,共7页
Little data exist on patients treated with tenofovir in Sub-Saharan Africa. Objective: To describe the clinical and laboratory characteristics of patients with viral hepatitis B treated with tenofovir. Material and me... Little data exist on patients treated with tenofovir in Sub-Saharan Africa. Objective: To describe the clinical and laboratory characteristics of patients with viral hepatitis B treated with tenofovir. Material and methods: A descriptive single-center retrospective study, on chronic viral hepatitis B mono-infected, followed in the hepatogastroenterology department of the University Hospital of Yopougon and treated with tenofovir from February 2012 to February 2015. The studied parameters were demographic, clinical, biochemical, serological, virological, abdominal ultrasound. Liver fibrosis was assessed either by liver biopsy or non-invasive tests. Results: 110 patients were treated with tenofovir disoproxil fumarate with a mean age of 40.4 years and a male predominance. Clinical examination revealed jaundice in 9% of cases, hepatomegaly in 7.3% of cases, splenomegaly in 9.1% of cases and ascites in 15.5% of cases. The AST averaged 77.3 IU/l, the ALT 76.8 IU/l, prothrombin rate at 76.6% , albumin level at 32.3 g/l, total bilirubin at 29.9 g/l, alpha fetoprotein rate at 15.3 ng/ml. HBe antigen was negative in 76.2% of cases. The average rate of DNA at baseline was 7.4 log10 IU/l. 27.5% was cirrhotic. The average time of starting treatment was 23.7 months. Conclusion: TDF is the first-line treatment for chronic hepatitis B in our country, because it is a well-tolerated, potent therapy with a high threshold for resistance development. Our study population had an average age of 40.4 years. Virological profile was dominated by HBe antigen negative patients and high viral load of HVB DNA. One third of patients were at the stage of cirrhosis. This treatment must be delivered free of charge in all the country hospitals, which is going to improve significantly the natural evolution of the disease and to decrease the incidence of the HCC. 展开更多
关键词 Chronic Hepatitis B Virus tenofovir disoproxil Fumarate TREATMENT Ivory Coast Sub-Saharan Africa
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Pre-Formulation Development of Lamivudine 300 mg and Tenofovir Disoproxil Fumarate (TDF) 300 mg Fixed Dose Combination Tablets
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作者 Prosper Tibalinda Dickson Pius +3 位作者 Raphael Shedafa Nelson Masota Mary Temu Eliangiringa Kaale 《Pharmacology & Pharmacy》 2016年第7期247-254,共8页
Introduction: In this study, physical and chemical characteristics of Lamivudine, Tenofovir Disoproxil Fumarate (TDF) and potential excipients were systematically followed and documented [1]. Objective: The objective ... Introduction: In this study, physical and chemical characteristics of Lamivudine, Tenofovir Disoproxil Fumarate (TDF) and potential excipients were systematically followed and documented [1]. Objective: The objective of this scientific work was to carry out pre-formulation studies including compatibility studies on Lamivudine and Tenofovir Disoproxil Fumarate with their potential excipients prior a direct compression process [2]. Methodology: The interaction was studied in three set of environments namely uncontrolled room conditions for Zone VI b (30°C ± 2°C), oven conditions in which the oven was set at 50°C and accelerated climatic conditions in which a climatic chamber was set at 40°C ± 2°C/75% ± 5% Relative Humidity (RH %). Sample preparation was done by mixing the amount of formulation excipients to active substances at a ratio of 1:10, whereas active substance to another active substance at a ratio of 1:1, active substance to coating materials at 1:4, coating materials to the whole set of excipients 1:4. The whole set of samples was geometrically mixed and triturated by mortar and pestle to very fine uniform powder to ensure homogeneity of the mixture. HPLC analytical method was used for simultaneous quantitative determination of lamivudine and tenofovir disoproxil fumarate. Transmittance of the mixture was determined by Near Infra-Red (NIR) technique. Results: The amount of Lamivudine as on day 0 was comparable to day 90 for in all tested conditions (Room, Oven and Climatic Chamber), whereas for Tenofovir Disoproxil Fumarate only the amount of the drug at Room (30°C ± 2°C) was comparable to results on day 90. A significant drop of amount of Tenofovir Disoproxil Fumarate (TDF) exposed to moisture (Climatic chamber at 40°C ± 2°C/75% ± 5% Relative Humidity (RH %)) and temperature of 50°C was observed. Colour change was observed for samples subjected to moisture (Climatic chamber at 40°C ± 2°C/75% ± 5% Relative Humidity (RH %)) and as well picked up in the NIR region 400 to 1500 cm<sup>-1</sup> (Finger print region) by a significant shift in Transmittance. Conclusion: It can be concluded that microcrystalline cellulose, cross linked sodium carboxymethyl cellulose, magnesium stearate and sodium carbxymethyl cellulose can be compressed together with Lamivudine and Tenofovir Disoproxil Fumarate (TDF) to produce a pharmaceutically acceptable solid dosage form, tablet. The produced tablets should be packed in moisture and light protective containers as Tenofovir Disoproxil Fumarate (TDF) has diester linkages which can be hydrolysed into the active drug Tenofovir in the presence of moisture. 展开更多
关键词 Compatibility INTERACTION Pre-Formulation Lamivudine and tenofovir disoproxil Fumarate
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Influence of Solvent Polarity on the Physio-Chemical Properties and Quantitative Determinations of Tenofovir Disoproxil and Emtricitabine with Chloranilic Acid as Complexing Agent
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作者 Johnson Ogoda Onah James Eromi Odeiani Ukpe Ajima 《Open Journal of Physical Chemistry》 2013年第1期30-39,共10页
Purpose: Tenofovir disoproxil fumarate (TEN) and emtricitabine (EMT) are both second generation ant-retroviral drugs used in the “treatment” of HIV/AIDS. The aim of this study is to establish the physic-chemical pro... Purpose: Tenofovir disoproxil fumarate (TEN) and emtricitabine (EMT) are both second generation ant-retroviral drugs used in the “treatment” of HIV/AIDS. The aim of this study is to establish the physic-chemical properties of their reaction with chloranilic acid in different solvent systems and to justify the chemical basis for simultaneous quantitative determination of these drugs in their combined formulation. Method: TEN and EMT were individually isolated from their single formulations and purified by chromatography to obtain secondary standard. Purity of the isolates were tested for by comparison with literature values. Stock solution of chloranilic acid (CA) [3.0 × 10﹣3 M] was prepared in the following solvents of different polarities: ethanol, acetonitrile, ethylacetate, chloroform and hexane. Equal volumes of CA and TEN [3.0 × 10﹣2 M] and EMT [3.0 × 10﹣2 M] dissolved in different solvents were mixed whereby colored products were observed. Absorption maxima were determined. Calibration curves were generated and validated. Quantitative simultaneous determination of TEN and EMT was determined by standard protocol. Stoichiometric relationships between the drugs and CA were established. Equilibrium constants were determined at different temperatures from which the Gibb’s free energies were calculated. Arrhenius equation was used to calculate the enthalpy, entropy was similarly calculated. Results: Absorption maxima of CA in different solvents are as follows: Ethanol 310 nm;Acetonitrile 330 nm;Ethyl acetate 340 nm;Chloroform 350 nm and hexane 310 nm. The complex of CA and TEN in the different solvents are: Alcohol 525 nm, Acetonitrile 500 nm;Ethyl acetate 505 nm;Chloroform 510 nm and hexane 515 nm. For EMT complex absorption maxima are: Alcohol 510 nm;Acetonitrile 515 nm’ Ethyl acetate 520 nm’ Chloroform 505 nm and hexane 530 nm. Simultaneous quantitative recovery values for TEN are: Ethanol;97.89% ± 1.21;Acetonitrile 101.17 V 1.51%;Ethyl acetate 96.55% ± 0.71%;Chloroform 99.11% ± 0.34% and hexane 98.03% ± 0.15%. For EMT the values are also: Ethanol: 98.92% ± 1.45%;Acetonitrile 100.471 ± 13;Ethyl acetate 97.06% ± 0.87%;Chloroform 99.31% ± 0.94% and Hexane 99.97% ± 1.63%. Stoichiometry of complexation showed a 1:1 ratio for both drugs. Equilibrium constants for TEN were highest in acetonitrile and least for Ethanol while for EMT, equilibrium constant was least for acetonitrile and highest in chloroform. Gibb’s free energy for TEN was least in ethanol and highest in acetonitrile. Gibb’s free energy for EMT was least in acetonitrile and highest in chloroform. Enthalpy for TEN was least in chloroform and highest in hexane. Similarly, the enthalpy for EMT was highest in chloroform and lowest in hexane. Conclusion: These results shows that solvent polarity influence charge transfer complexes in a non consistent fashion. The structure of the donor might have contributed to thermodynamics of complexation since orbital overlap may vary from solvent to solvent. For quantitative analysis hexane appears to be the most suitable solvent because it has the highest molar absorptivity and higher enthalpy of interactions. Molecules that can donate electrons and their stereochemistry could contribute to intensity of absorption maxima of the electronic transitions. 展开更多
关键词 tenofovir disoproxil FUMARATE EMTRICITABINE PHYSICO-CHEMICAL STUDIES CHARGE-TRANSFER
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Differences of Efficacy Between Tenofovir Alafenamide Fumarate and Tenofovir Disoproxil Fumarate in Pregnant Women With Different Hepatitis B Virus DNA Loads
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作者 Chengjing Tao Guanlun Zhou +6 位作者 Hongxiu Jiang Chao Chen Yuhao Ju Xingran Tao Ping Zhang Shuorong Liu Guorong Han 《Infectious Microbes & Diseases》 CSCD 2024年第3期134-140,共7页
Tenofovir alafenamide fumarate(TAF)has been endorsed by guidelines for blockade ofmother-to-child transmission of hepatitis B virus(HBV),given that its efficacy and safety are comparable to tenofovir disoproxil fumara... Tenofovir alafenamide fumarate(TAF)has been endorsed by guidelines for blockade ofmother-to-child transmission of hepatitis B virus(HBV),given that its efficacy and safety are comparable to tenofovir disoproxil fumarate(TDF).However,there is a lack of comparative studies regarding the treatment efficacy in patients with diverse viral loads.This study retrospectively analyzed 96 hepatitis B e antigen(HBeAg)–positive pregnant women with HBV DNA levels of≥2×10^(5) IU/mL.Based on viral loads(HBV DNA levels),participants in the TAF and TDF groups were stratified into three subgroups,namely,the High-G(titer≥8 log10 IU/mL),Middle-G(7 log10 IU/mL≤titer<8 log10 IU/mL)and Low-G(titer<7 log10 IU/mL)subgroups.The primary endpoint was effectiveness of TAF and TDF in patients with varying viral loads,whereas secondary endpoints were hepatitis B surface antigen(HBsAg)positivity in infants at 7 to 12 months and the safety profile for mothers and children.Compared with baseline levels,median HBV DNA levels in mothers were decreased by 4.51 and 4.09 log10 IU/mL in the TAF andTDF groups(P=0.04)predelivery,respectively.In the High-G subgroup,the titers were significantly lower in the TAF group(P=0.045).A higher proportion of patients experienced a virus decline of≥4 log10 IU/mL in the TAF group compared with the TDF group,with rates of 78.26% versus 58%(P=0.034),respectively.Moreover,the median serum phosphate levels significantly decreased frombaseline to predelivery in the TDF group(P=0.04).Finally,infants in both cohorts tested negative for HBsAg at 7–12 months after delivery.Overall,our findings indicate that TAF can be considered the preferred option for the treatment of HBeAgpositive pregnant women with HBV DNA levels of≥8 log10 IU/mL. 展开更多
关键词 hepatitis B virus tenofovir alafenamide fumarate tenofovir disoproxil fumara HBeAg positive HBV DNA
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Rapid Recovery in COVID-19 Patients with Chronic Hepatitis B Virus Infection Treated with Tenofovir Disoproxil Fumarate 被引量:2
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作者 Xiliu Chen Di Liu +1 位作者 Dongliang Yang Xin Zheng 《Journal of Clinical and Translational Hepatology》 SCIE 2021年第2期269-273,共5页
The coronavirus disease 2019(COVID-19)pandemic continues worldwide.We report here two cases of chronic hepatitis B patients with acute respiratory syndrome coronavirus 2 infection treated with tenofovir disoproxil fum... The coronavirus disease 2019(COVID-19)pandemic continues worldwide.We report here two cases of chronic hepatitis B patients with acute respiratory syndrome coronavirus 2 infection treated with tenofovir disoproxil fumarate who demonstrated a favorable outcome.This report adds some evidence that concurrent HBV infection may not worsen COVID-19 infection and tenofovir disoproxil fumarate treatment may have partial positive effect on COVID-19 rapid recovery. 展开更多
关键词 COVID-19 SARS-CoV-2 Chronic hepatitis B tenofovir disoproxil fumarate
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富马酸丙酚替诺福韦对高病毒载量慢性乙型肝炎病毒感染母婴阻断的分析
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作者 温井奎 曹立华 +6 位作者 李仕武 丁丽娜 盖亚会 王晓荣 贺艺杰 邹怀宾 段钟平 《遵义医科大学学报》 2024年第9期892-896,共5页
目的对比富马酸丙酚替诺福韦(TAF)、富马酸替诺福韦二吡呋酯(TDF)用于慢性乙肝病毒(HBV)感染的高病毒载量母婴阻断有效性及安全性。方法前瞻性选取高病毒载量孕妇116例,分为TAF组(56例)和TDF组(60例),在第24~28孕周开始服药,两组均分别... 目的对比富马酸丙酚替诺福韦(TAF)、富马酸替诺福韦二吡呋酯(TDF)用于慢性乙肝病毒(HBV)感染的高病毒载量母婴阻断有效性及安全性。方法前瞻性选取高病毒载量孕妇116例,分为TAF组(56例)和TDF组(60例),在第24~28孕周开始服药,两组均分别在24~28孕周、32~36孕周及分娩时检测HBV DNA、HBsAg和HBeAg,新生儿分别在出生时、7月龄时检测HBV DNA、HBsAg和HBeAg。结果分娩时两组孕妇血清HBV DNA降至2.0×10~5 IU/mL以下的病例数,TAF组占92.9%,TDF组占95%;TAF组57例新生儿(1例为双胞胎),出生时HBsAg阳性4例,占7.01%,HBV DNA阳性1例,占1.75%,TDF组60例新生儿,出生时HBsAg阳性2例,占3.33%,HBV DNA均阴性。两组新生儿7月龄时HBsAg、HBV DNA均阴性,均产生抗HBs,阻断成功率100%,两组孕妇均未见明显不良反应,新生儿出生时、28、48、96周均未见明显生长发育障碍。结论TAF用于慢性HBV感染的高病毒载量的母婴阻断有效且安全。 展开更多
关键词 富马酸丙酚替诺福韦 富马酸替诺福韦二吡呋酯 高HBV载量 母婴传播 阻断
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基于真实世界数据的不同用药方案对艾滋病患者血脂水平的影响分析
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作者 居宇峰 王丹丹 《东南大学学报(医学版)》 CAS 2024年第4期580-585,共6页
目的:基于真实世界数据分析不同用药方案对艾滋病患者血脂的影响。方法:基于医院信息系统(HIS)中真实世界数据,采用分层随机抽样法选取本省16家三级甲等医院,收集2022年1月至7月在上述医院中采用不同用药方案的702例艾滋病患者的病历资... 目的:基于真实世界数据分析不同用药方案对艾滋病患者血脂的影响。方法:基于医院信息系统(HIS)中真实世界数据,采用分层随机抽样法选取本省16家三级甲等医院,收集2022年1月至7月在上述医院中采用不同用药方案的702例艾滋病患者的病历资料,根据其采用的用药方案分为方案1组[拉米夫定(3TC)+齐多夫定(AZT)+依非韦伦(EFV)]、方案2组[3TC+AZT+奈拉伟平(NVP)]、方案3组[3TC+富马酸替诺福韦酯(TDF)+EFV]和方案4组(3TC+TDF+NVP)。比较各组患者治疗前、治疗6个月后的空腹血脂[总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)和高密度脂蛋白胆固醇(HDL-C)]水平和血脂异常率;比较各组患者用药期间血脂变化导致不良事件的发生情况。结果:治疗后,各组患者TC、TG、LDL-C水平及血脂异常率高于治疗前,HDL-C水平低于治疗前,且方案3组、方案4组患者TC、TG、LDL-C水平及血脂异常率分别低于方案1组、方案2组,HDL-C水平分别高于方案1组、方案2组(均P<0.05);方案3组、方案4组患者用药期间血脂变化导致不良事件的发生率分别低于方案1组、方案2组(均P<0.05)。结论:与3TC+AZT+EFV、3TC+AZT+NVP治疗方案相比,3TC+TDF+EFV、3TC+TDF+NVP治疗方案可降低艾滋病患者TC、TG、LDL-C水平,提高HDL-C水平,改善血脂异常,减少血脂异常导致的不良事件。 展开更多
关键词 真实世界数据 富马酸替诺福韦酯 艾滋病 血脂
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复方栀子根颗粒联合替诺福韦酯对慢性乙型肝炎患者血清细胞因子水平的影响
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作者 张婷 裴晓华 +3 位作者 蔡虹 吴剑华 徐振兴 王敏 《中西医结合肝病杂志》 CAS 2024年第3期210-214,共5页
目的:观察复方栀子根颗粒联合替诺福韦酯(TDF)治疗慢性乙型肝炎(CHB)患者的临床疗效及对细胞因子的影响。方法:纳入CHB初治患者80例,采用临床随机对照研究,除去脱落及剔除病例,共纳入分析75例(治疗组35例、对照组40例)。对照组患者给予... 目的:观察复方栀子根颗粒联合替诺福韦酯(TDF)治疗慢性乙型肝炎(CHB)患者的临床疗效及对细胞因子的影响。方法:纳入CHB初治患者80例,采用临床随机对照研究,除去脱落及剔除病例,共纳入分析75例(治疗组35例、对照组40例)。对照组患者给予口服TDF,治疗组患者在对照组基础上加用复方栀子根颗粒,两组患者均在治疗4周、24周时比较肝功能(ALT、AST、GGT)变化,在治疗24周比较病毒学指标(HBV DNA、HBsAg、HBeAg)、细胞因子(IL-6、IL-10、IL-17、IL-23)水平及临床疗效判定。结果:两组患者治疗24周后肝功能、病毒学指标、细胞因子水平均较治疗前显著降低(P<0.05)。组间比较,治疗4周后治疗组转氨酶下降水平更低,差异有统计学意义(Z=-2.90,P=0.004;Z=-3.26,P=0.001;Z=-2.24,P=0.025);治疗组24周时IL-6、IL-23水平较对照组低,差异有统计学意义(Z=-2.14,P=0.033;Z=-2.10,P=0.036);治疗组总有效率97.14%(34/35),对照组95.00%(38/40),治疗组总有效率高于对照组(χ2=9.49,P=0.019);治疗组较对照组不良反应更少,差异有统计学意义(χ2=6.19,P=0.044)。结论:复方栀子根颗粒联合TDF治疗早期能更快降低转氨酶水平,降低促炎细胞因子水平及提高临床综合疗效优于单用TDF,并减轻临床不良反应。 展开更多
关键词 慢性乙型肝炎 复方栀子根颗粒 中药复方 疗效观察 细胞因子 替诺福韦
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替诺福韦对肝星状细胞活化及CCR2表达水平的影响
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作者 孙静 丁奕栋 张一思 《医药前沿》 2024年第29期1-4,共4页
目的:研究药物替诺福韦(TDF)对人肝星状细胞(LX-2)的CC趋化因子受体2(CCR2)表达的影响,探讨TDF在肝纤维化疾病发展中发挥抗纤维化的作用机制。方法:以LX-2作为体外实验研究对象,使用HE染色观察用药后细胞增殖情况。利用蛋白质印迹法检... 目的:研究药物替诺福韦(TDF)对人肝星状细胞(LX-2)的CC趋化因子受体2(CCR2)表达的影响,探讨TDF在肝纤维化疾病发展中发挥抗纤维化的作用机制。方法:以LX-2作为体外实验研究对象,使用HE染色观察用药后细胞增殖情况。利用蛋白质印迹法检测使用不同浓度TDF和CCR2小干扰RNA(siRNA)对LX-2细胞α平滑肌肌动蛋白(α-SMA)及CCR2蛋白表达水平的影响。结果:siRNA沉默CCR2表达可显著下调肝纤维化相关蛋白α-SMA表达(P<0.01);TDF抑制LX-2细胞的增殖活化,明显降低细胞CCR2及α-SMA的蛋白表达水平(P<0.01)。结论:TDF可通过抑制CCR2表达抑制肝星状细胞活化,发挥抗肝纤维化作用。 展开更多
关键词 肝纤维化 替诺福韦 抗纤维化作用 CC趋化因子受体2
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恩替卡韦、富马酸替诺福韦二吡呋酯及富马酸丙酚替诺福韦治疗慢性乙型肝炎的疗效及安全性分析 被引量:1
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作者 程家喜 王万党 +5 位作者 石梅彬 黄祥亚 杨洁 李巧珊 邹绮明 李娟 《传染病信息》 2024年第1期11-15,共5页
目的观察恩替卡韦(entecavir,ETV)、富马酸替诺福韦二吡呋酯(tenofovir disoproxil fumarate,TDF)及富马酸丙酚替诺福韦(tenofovir alafenamide fumarate,TAF)抗病毒治疗慢性乙型病毒性肝炎(慢乙肝)的临床疗效及安全性。方法选择2021年... 目的观察恩替卡韦(entecavir,ETV)、富马酸替诺福韦二吡呋酯(tenofovir disoproxil fumarate,TDF)及富马酸丙酚替诺福韦(tenofovir alafenamide fumarate,TAF)抗病毒治疗慢性乙型病毒性肝炎(慢乙肝)的临床疗效及安全性。方法选择2021年3月—2023年6月我院收治的181例慢乙肝患者,依据抗病毒治疗用药不同分为3组,ETV组(n=66)、TDF组(n=64)及TAF组(n=51)。比较3组患者的血脂、肝功能、HBsAg、HBV DNA、血肌酐及估算的肾小球滤过率(estimated glomerular filtration rate,eGFR)等指标在治疗前后及组间的差异。结果ETV组有效率为86.36%(57/66),TDF组有效率为90.63%(58/64),TAF组有效率为90.20%(46/51),3组比较差异无统计学意义(P>0.05)。治疗后,3组的HBsAg水平、HBV DNA载量均低于治疗前(P均<0.05),且3组间HBsAg水平、HBV DNA载量的变化幅度比较,差异具有统计学意义(P<0.05)。治疗后,3组的ALT、AST水平均低于治疗前(P均<0.05),且3组间ALT、AST水平的变化幅度比较,差异有统计学意义(P<0.05)。治疗后,ETV组的HDL-C、LDL-C均高于治疗前(P均<0.05),TC、TG较治疗前差异均无统计学意义(P均>0.05);TDF组的TC、HDL-C均低于治疗前(P均<0.05),TG、LDL-C较治疗前差异均无统计学意义(P均>0.05);TAF组的TC、TG、HDL-C、LDL-C较治疗前差异均无统计学意义(P均>0.05),但3组间TC、TG、HDL-C、LDL-C的变化幅度比较,差异均有统计学意义(P均<0.05)。治疗后,3组的血肌酐、eGFR较治疗前差异均无统计学意义(P均>0.05),但3组间血肌酐、eGFR的变化幅度比较,差异均有统计学意义(P均<0.05)。结论ETV、TDF、TAF治疗慢乙肝的临床疗效相近,服用TAF不会对血脂造成影响,但服用ETV会引起HDL-C、LDL-C水平升高,服用TDF可降低TC、HDL-C水平,并且均有较好的肾脏安全性。 展开更多
关键词 核苷(酸)类似物 抗病毒 慢性乙型肝炎 血脂 恩替卡韦 富马酸替诺福韦二吡呋酯 富马酸丙酚替诺福韦
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清热利湿化浊方在治疗慢性乙型肝炎肝硬化中作用及对肝功能和乙型肝炎病毒定量的影响
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作者 戎蓉 连博 范兴刚 《中华中医药学刊》 CAS 北大核心 2024年第4期26-29,共4页
目的探讨清热利湿化浊方联合富马酸替诺福韦二吡呋酯片治疗慢性乙型肝炎病毒(乙肝)(Hepatitis B virus,HBV)肝硬化的疗效及对肝功能和乙肝病毒定量的影响。方法选择医院于2020年5月—2022年5月慢性乙肝肝硬化患者82例,运用随机表法分为... 目的探讨清热利湿化浊方联合富马酸替诺福韦二吡呋酯片治疗慢性乙型肝炎病毒(乙肝)(Hepatitis B virus,HBV)肝硬化的疗效及对肝功能和乙肝病毒定量的影响。方法选择医院于2020年5月—2022年5月慢性乙肝肝硬化患者82例,运用随机表法分为观察组41例与对照组41例。对照组给予富马酸替诺福韦二吡呋酯片治疗,观察组在富马酸替诺福韦二吡呋酯片基础上结合清热利湿化浊方治疗。两组治疗疗程24周。比较两组治疗24周临床疗效;治疗前后肝功能,肝纤维化,乙肝病毒脱氧核糖核酸(hepatitis B virus deoxyribonucleic acid,HBV DNA)载量,炎性因子,Toll样受体4(Toll-like receptor4,TLR4)和c-Jun氨基末端激酶(c-Jun N-terminal kinase Messenger RNA,JNK)mRNA表达。结果观察组总有效率高于对照组(P<0.05)。两组治疗后天冬氨酸氨基转移酶(Aspartate aminotransferase,AST)、总胆红素(Total bilirubin,TBIL)和丙氨酸氨基转移酶(Alanine aminotransferase,ALT)水平低于治疗前(P<0.05);观察组治疗后AST、TBIL和ALT水平低于对照组(P<0.05)。两组治疗后透明质酸(Hyaluronic acid,HA)、层黏连蛋白(Laminin,LN)、Ⅲ型前胶原(Procollagen typeⅢ,PCⅢ)和Ⅳ型胶原(Collagen type IV,CⅣ)水平低于治疗前(P<0.05);观察组治疗后HA、LN、PCⅢ和CⅣ水平低于对照组(P<0.05)。两组治疗后HBV DNA载量低于治疗前(P<0.05);观察组治疗后HBV DNA载量低于对照组(P<0.05)。两组治疗后白介素(interleukin,IL)-6、IL-8和肿瘤坏死因子-α(tumor necrosisfactor-α,TNF-α)水平低于治疗前(P<0.05);观察组治疗后IL-6、IL-8和TNF-α水平低于对照组(P<0.05)。两组治疗后TLR4和JNK mRNA表达低于治疗前(P<0.05);观察组治疗后TLR4和JNK mRNA表达低于对照组(P<0.05)。结论清热利湿化浊方联合富马酸替诺福韦二吡呋酯片治疗慢性乙肝肝硬化患者疗效显著,且可改善患者肝功能,降低乙肝病毒载量,减轻炎症反应,及下调TLR4/JNK信号传导通路。 展开更多
关键词 清热利湿方 富马酸替诺福韦二吡呋酯片 慢性乙型肝炎 肝硬化
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恩替卡韦与富马酸替诺福韦酯治疗对慢性乙型肝炎患者肾功能的影响
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作者 张秀彬 刘淑霞 刘宁 《中华保健医学杂志》 2024年第4期477-480,共4页
目的 观察无明显肾功能损害慢性乙型肝炎(chronic hepatitis B,CHB)患者采用恩替卡韦(entecavir, ETV)、富马酸替诺福韦酯(tenofovir disoproxil fumarate, TDF)单药治疗对肾功能的影响。方法 选取保定市第四中心医院2020年1月~2021年1... 目的 观察无明显肾功能损害慢性乙型肝炎(chronic hepatitis B,CHB)患者采用恩替卡韦(entecavir, ETV)、富马酸替诺福韦酯(tenofovir disoproxil fumarate, TDF)单药治疗对肾功能的影响。方法 选取保定市第四中心医院2020年1月~2021年12月接受抗病毒治疗的CHB患者,根据患者基线肾小球滤过率估计值(estimated glomerular filtration rate, EGFR)水平分为eGFR> 90 ml/(min·1.73 m^(2))组(n=79)和60~90 ml/(min·1.73 m^(2))组(n=38),分别比较ETV和TDF治疗效果,并对治疗24和48周后的肾小球滤过率eGFR、尿视黄醇结合蛋白(retinol-binding protein, RBP)、α1微球蛋白(α1-microglobulin, α1-MG)和β2微球蛋白(β2-microglobulin, β2-MG)进行比较。结果 治疗前,eGFR> 90 ml/(min·1.73 m^(2))组和60~90 ml/(min·1.73 m^(2))组患者血清谷丙转氨酶(ALT)、乙型肝炎病毒表面抗原(HBSAG)、乙型肝炎病毒(HBV)DNA差异无统计学意义(P> 0.05)。治疗后,eGFR> 90 ml/(min·1.73 m^(2))组和60~90 ml/(min·1.73 m^(2))组不同治疗用药患者患者ALT、HBsAg均下降,与治疗前比较,差异有统计学意义(t=12.234、10.313、3.802、3.604,9.431、7.419、3.508、4.147,P<0.05)。治疗48周后,ALT、HBsAg水平及HBV DNA病毒应答率差异均无统计学意义(P> 0.05)。入组时两组eGFR、尿RBP、α1-MG和β2-MG比较,差异无统计学意义(P> 0.05)。治疗24和48周后,两组组间eGFR、尿RBP、β2-MG差异及与入组时比较差异均无统计学意义(P> 0.05)。eGFR> 90 ml/(min·1.73 m^(2))患者治疗前后及ETV、TDF治疗24周、48周后α1-MG差异无统计学意义(P> 0.05),eGFR60~90 ml/(min·1.73 m^(2))患者24周后α1-MG差异无统计学意义(P> 0.05),48周后TDF组α1-MG高于ETV组也高于入组时,差异有统计学意义(t=2.169、2.859,P<0.05)。结论 恩替卡韦与替诺福韦酯均可有效抑制慢性乙型肝炎患者HBV DNA复制,对于eGFR <90 ml/(min·1.73 m^(2))患者,建议选择恩替卡韦以减少对肾小管的早期损伤。 展开更多
关键词 恩替卡韦 替诺福韦酯 慢性乙型肝炎 肾功能
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富马酸替诺福韦酯和富马酸丙酚替诺福韦序贯联合聚乙二醇干扰素α-2b治疗慢性乙型肝炎患者的疗效比较 被引量:1
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作者 蔡纲 高庆娥 史元建 《黑龙江医药科学》 2024年第1期154-157,共4页
目的:比较富马酸替诺福韦酯(tenofovir disoproxil fumarate,TDF)和富马酸丙酚替诺福韦(tenofovir alafenamide fumarate,TAF)两种药物序贯加用聚乙二醇干扰素α-2b在慢性乙型肝炎患者中的疗效。方法:选取慢性乙型肝炎患者160例,根据用... 目的:比较富马酸替诺福韦酯(tenofovir disoproxil fumarate,TDF)和富马酸丙酚替诺福韦(tenofovir alafenamide fumarate,TAF)两种药物序贯加用聚乙二醇干扰素α-2b在慢性乙型肝炎患者中的疗效。方法:选取慢性乙型肝炎患者160例,根据用药方案不同分成实验组和对照组各80例,分别接受TAF治疗和TDF治疗,均治疗24周后加用聚乙二醇干扰素α-2b治疗72周。观察指标包括HBV-DNA阴转率、HBeAg阴转率、HBsAg阴转率、HBsAg滴度、HBVDNA定量和ALT水平。结果:共有128例参与者完成了研究,其中实验组62例,对照组66例。96周时,实验组的HBsAg转化率、HBsAg滴度和HBVDNA定量明显优于对照组,差异有统计学意义(P<0.05)。实验组的HBVDNA清除率和e抗原转化率也高于对照组,但差异接近显著(P=0.058和P=0.085)。实验组的ALT值在72周和96周时均低于对照组,差异有统计学意义(P<0.05)。结论:TAF联合长效干扰素治疗慢性乙型肝炎疗效明显优于TDF联合长效干扰素,可以有效改善患者的病毒学指标和肝功能,是一种更为有效的治疗方案。 展开更多
关键词 慢性乙型肝炎 富马酸替诺福韦酯 富马酸丙酚替诺福韦 聚乙二醇干扰素
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富马酸替诺福韦在治疗低病毒载量慢性乙肝患者中的效果分析
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作者 闫怡儒 张玉 郭春霞 《临床研究》 2024年第11期50-53,共4页
目的探究低病毒载量慢性乙肝(CHB)患者的治疗期间应用富马酸替诺福韦(TDF)的价值。方法选取南阳医学高等专科学校第一附属医院2021年4月至2024年1月期间医院感染性疾病科诊治的72例低病毒载量CHB患者,其均符合低病毒载量的治疗标准,依... 目的探究低病毒载量慢性乙肝(CHB)患者的治疗期间应用富马酸替诺福韦(TDF)的价值。方法选取南阳医学高等专科学校第一附属医院2021年4月至2024年1月期间医院感染性疾病科诊治的72例低病毒载量CHB患者,其均符合低病毒载量的治疗标准,依据用药计划的差异,将其分为研究组(n=36,TDF)、对照组(n=36,常规治疗),比较两组疗效、肝功能指标、肝纤维化指标以及恢复情况。结果治疗后,研究组治疗有效率(97.22%)显著高于对照组(75.00%),差异有统计学意义(P<0.05);治疗前,两组肝功能、肝纤维化指标比较差异无统计学意义(P>0.05),治疗后,两组肝功能、肝纤维化指标均降低,且研究组低于对照组,差异有统计学意义(P<0.05);治疗后,研究组乙肝病毒-脱氧核糖核酸(HBV-DNA)转阴率、乙肝e抗原(HBeAg)转阴率、血清丙氨酸氨基转移酶(ALT)复常率均高于对照组,差异有统计学意义(P<0.05)。结论低病毒载量CHB患者治疗期间应用TDF较为理想,能够提升临床疗效,改善总胆红素、ALT等肝功能相关指标,进而优化HBV-DNA转阴率、HBeAg转阴率、ALT复常率,具有临床应用意义。 展开更多
关键词 富马酸替诺福韦 慢性乙肝 治疗效果 低病毒载量
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肝癌合并HBV感染患者使用富马酸替诺福韦二吡呋酯致肾损伤1例并文献分析
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作者 曹磊 汪丰 +1 位作者 刘继勇 常莹莹 《中国药房》 CAS 北大核心 2024年第7期866-871,共6页
富马酸替诺福韦二吡呋酯(TDF)是慢性乙型肝炎的一线治疗用药,随着该药在全球范围内使用的增加,其所致肾损伤的不良事件也引起了业界重视。本文报道了1例61岁既往合并乙型肝炎病毒(HBV)感染的肝癌患者,于2022年3月中旬开始使用TDF,用药2... 富马酸替诺福韦二吡呋酯(TDF)是慢性乙型肝炎的一线治疗用药,随着该药在全球范围内使用的增加,其所致肾损伤的不良事件也引起了业界重视。本文报道了1例61岁既往合并乙型肝炎病毒(HBV)感染的肝癌患者,于2022年3月中旬开始使用TDF,用药2个月后出现肾损伤,其间进行了2个疗程的多纳非尼联合信迪利单抗化疗,同时不规律服用双氯芬酸缓解疼痛。本文使用Naranjo’s评估量表评估出与肾损伤可能相关的药物有TDF和信迪利单抗,可疑相关的药物为多纳非尼和双氯芬酸;结合患者的病情变化、药物致肾损伤的发生率、临床表现、发生时间、发生机制、合并用药及高危因素,最终判断为TDF导致的肾损伤。临床应动态监测肝癌合并HBV感染患者使用TDF后的血肌酐变化情况,必要时可调整抗病毒药物的剂量和选择其他对肾功能影响较小的抗病毒药物,以期为肿瘤患者提供个体化用药建议,降低TDF相关肾损伤发生率。 展开更多
关键词 富马酸替诺福韦二吡呋酯 乙型肝炎病毒 肝癌 肾损伤 药物不良反应 文献分析
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基于FAERS数据库的丙酚替诺福韦和富马酸替诺福韦二吡呋酯不良事件信号挖掘与分析
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作者 李姜楠 王宇 +1 位作者 宁红 田雅兰 《实用药物与临床》 2024年第1期16-21,共6页
目的基于美国食品药品监督管理局不良事件报告系统(FAERS)数据库对富马酸替诺福韦二吡呋酯和丙酚替诺福韦上市后的不良事件(ADE)信号进行挖掘和评价,比较两者安全性的差异。方法采用报告比值比法(ROR)和比例报告比值比法(PRR),对FAERS... 目的基于美国食品药品监督管理局不良事件报告系统(FAERS)数据库对富马酸替诺福韦二吡呋酯和丙酚替诺福韦上市后的不良事件(ADE)信号进行挖掘和评价,比较两者安全性的差异。方法采用报告比值比法(ROR)和比例报告比值比法(PRR),对FAERS数据库2017年第1季度至2022年第4季度共24个季度的报告进行数据挖掘,筛选出ROR法和PRR法共同检测获得的不良事件信号,通过监管活动医学词典(MedDRA)系统器官分类(SOC)对信号进行标准化分类。结果获得以富马酸替诺福韦二吡呋酯为首要怀疑药物的ADE 175960例,以丙酚替诺福韦为首要怀疑药物的ADE 2936例,使用ROR法和PRR法共同挖掘到富马酸替诺福韦二吡呋酯ADE信号120个,丙酚替诺福韦ADE信号78个。富马酸替诺福韦二吡呋酯ADE主要累及SOC:各类损伤、中毒及手术并发症(占23.89%)、各类肌肉骨骼及结缔组织疾病(占21.75%)、肾脏及泌尿系统疾病(占28.95%);丙酚替诺福韦ADE主要累及SOC:各类检查(15.77%)、各类神经系统疾病(14.70%)、胃肠系统疾病(11.70%)等。结论丙酚替诺福韦在肾脏系统和骨骼系统方面安全性高于富马酸替诺福韦二吡呋酯,但是丙酚替诺福韦ADE较为分散,临床用药时需注意丙酚替诺福韦偶见或罕见的ADE。 展开更多
关键词 富马酸替诺福韦二吡呋酯 丙酚替诺福韦 药物不良事件 信号挖掘 合理用药
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富马酸丙酚替诺福韦联合复方鳖甲软肝片治疗乙型肝炎肝硬化患者疗效和安全性评估
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作者 连作勤 王世明 +1 位作者 张甲 李付平 《实用肝脏病杂志》 CAS 2024年第5期753-756,共4页
目的观察富马酸丙酚替诺福韦(TAF)联合复方鳖甲软肝片治疗乙型肝炎肝硬化患者的效果。方法2021年6月~2023年6月我院收治的乙型肝炎肝硬化患者116例,被随机分为两组,每组58例。给予对照组患者口服TAF治疗,给予观察组TAF联合复方鳖甲软肝... 目的观察富马酸丙酚替诺福韦(TAF)联合复方鳖甲软肝片治疗乙型肝炎肝硬化患者的效果。方法2021年6月~2023年6月我院收治的乙型肝炎肝硬化患者116例,被随机分为两组,每组58例。给予对照组患者口服TAF治疗,给予观察组TAF联合复方鳖甲软肝片治疗,两组均治疗观察6个月。常规检测血清HBV标记物和HBV DNA载量,采用放射免疫分析法检测血清透明质酸(HA)、层粘连蛋白(LN)、Ⅲ型前胶原(PIIIP)和Ⅳ型胶原(CIV),使用超声检测肝脏剪切波弹性成像(SWE)和门脉指标。结果在治疗6个月末,观察组血清ALT水平为(43.1±6.2)U/L,显著低于对照组【(62.6±7.8)U/L,P<0.05】,而两组血清TBIL、ALB和INR比较,无显著性差异(P>0.05);两组血清HBV DNA均转阴,但血清HBsAg和HBeAg水平均无变化;观察组血清透明质酸、Ⅲ型前胶原和Ⅳ型胶原水平分别为(82.2±10.3)ng/L、(94.8±11.5)ng/mL和(61.3±7.5)ng/mL,均显著低于对照组【分别为(123.1±11.9)ng/L、(132.1±13.8)ng/mL和(89.7±9.1)ng/mL,P<0.05】;观察组SWE为(11.2±2.0)kPa,显著低于对照组【(14.1±2.5)kPa,P<0.05】,而两组门静脉内径和脾静脉内径比较,无显著性差异(P>0.05)。结论应用TAF联合复方鳖甲软肝片治疗乙型肝炎肝硬化患者可加速肝功能指标的恢复,抗肝纤维化作用明显,其长期疗效还有待于进一步观察。 展开更多
关键词 肝硬化 乙型肝炎 富马酸丙酚替诺福韦 复方鳖甲软肝片 肝纤维化 治疗
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鳖甲煎丸联合富马酸替诺福韦二吡呋酯片治疗乙型肝炎肝硬化的疗效及对肝功能的影响
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作者 黄丽芳 黄芬 曹小犬 《临床合理用药杂志》 2024年第32期4-7,共4页
目的观察鳖甲煎丸联合富马酸替诺福韦二吡呋酯片治疗乙型肝炎(乙肝)肝硬化的疗效及对肝功能的影响。方法选取2022年6月—2023年6月九江市第三人民医院收治的乙肝肝硬化患者90例,采用随机数字表法分为观察组和对照组,每组45例。在常规治... 目的观察鳖甲煎丸联合富马酸替诺福韦二吡呋酯片治疗乙型肝炎(乙肝)肝硬化的疗效及对肝功能的影响。方法选取2022年6月—2023年6月九江市第三人民医院收治的乙肝肝硬化患者90例,采用随机数字表法分为观察组和对照组,每组45例。在常规治疗基础上,对照组予富马酸替诺福韦二吡呋酯片治疗,观察组在对照组基础上予鳖甲煎丸治疗,2组疗程均为6个月。比较2组治疗效果,治疗前后肝功能指标[血清丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、总胆红素(TBil)]、肝纤维化指标[血清层粘连蛋白(LN)、Ⅲ型前胶原(PCⅢ)、透明质酸(HA)]、乙肝病毒定量[乙肝病毒DNA(HBV-DNA)、乙肝病毒核心抗体(HBcAb)]水平变化,以及不良反应。结果观察组治疗总有效率为88.89%,高于对照组的68.89%(χ^(2)=5.404,P=0.020);治疗6个月后,2组ALT、AST、TBil、LN、PCⅢ、HA水平及HBV-DNA、HBcAb均较治疗前降低,且观察组低于对照组(P均<0.01);观察组与对照组不良反应总发生率(13.33%vs.17.78%)比较差异无统计学意义(χ^(2)=0.338,P=0.561)。结论鳖甲煎丸联合富马酸替诺福韦二吡呋酯片治疗乙肝肝硬化的疗效较好,可促进患者的肝功能恢复,降低肝纤维化程度,且可降低乙肝病毒定量,安全可靠。 展开更多
关键词 肝硬化 乙型肝炎 鳖甲煎丸 富马酸替诺福韦二吡呋酯片 肝功能 肝纤维化指标
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