Progress in the Study of Vonoprazan Fumarate vs. Proton Pump Inhibitors in the Treatment of Gastroesophageal Reflux Disease

Gastroesophageal reflux disease (GERD) is a common gastrointestinal disease, and proton pump inhibitors (PPIs) have been recommended as the first-line treatment for GERD. In recent years, studies on vonoprazan fumarate in the treatment of GERD have attracted widespread attention. In this paper, we review the research progress of vonoprazan fumarate and proton pump inhibitors in the treatment of GERD in recent years, and compare and analyze the efficacy, safety, tolerability, and advantages and disadvantages of long-term application of both. By reviewing the relevant literature, we found that vonoprazan fumarate has similar performance with proton pump inhibitors in terms of efficacy and safety, but has potential advantages in terms of tolerability and long-term application. Therefore, we believe that vonoprazan fumarate may become a new option for GERD treatment, helping clinicians to develop more appropriate treatment plans for patients and providing new ideas and directions for research in related fields.

Macrophage fumarate hydratase restrains mtRNA-mediated interferon production

Metabolic rewiring underlies the effector functions of macrophages1-3,but the mechanisms involved remain incompletely defined.Here,using unbiased metabolomics and stable isotope-assisted tracing,we show that an inflammatory aspartate argininosuccinate shunt is induced following lipopolysaccharide stimulation.The shunt,supported by increased argininosuccinate synthase(ASS1)expression,also leads to increased cytosolic fumarate levels and fumarate-mediated protein succination.Pharmacological inhibition and genetic ablation of the tricarboxylic acid cycle enzyme fumarate hydratase(FH)further increases intracellular fumarate levels.

Treatment with dimethyl fumarate ameliorates liver ischemia/reperfusion injury

AIM To investigate the hypothesis that treatment with dimethyl fumarate(D MF) mayame liorate liver ischemia/reperfusion injury(I/RI).METHODS Rats were divided into 3 groups: sham, control(CTL), and DMF. DMF(25 mg/kg, twice/d) was orally administered for 2 d before the procedure. The CTL and DMF rats were subjected to ischemia for 1 h and reperfusion for 2 h. The serum alanine aminotransferase(ALT) and malondialdehyde(MDA) levels, adenosine triphosphate(ATP), NO × metabolites, anti-oxidant enzyme expression level, antiinflammatory effect, and anti-apoptotic effect were determined.RESULTS Histological tissue damage was significantly reduced in the DMF group(Suzuki scores: sham: 0 ± 0; CTL: 9.3± 0.5; DMF: 2.5 ± 1.2; sham vs CTL, P < 0.0001; CTL vs DMF, P < 0.0001). This effect was associated with significantly lower serum ALT(DMF 5026 ± 2305 U/L vs CTL 10592 ± 1152 U/L, P = 0.04) and MDA(DMF 18.2 ± 1.4 μmol/L vs CTL 26.0 ± 1.0 μmol/L, P = 0.0009). DMF effectively improved the ATP content(DMF 20.3 ± 0.4 nmol/mg vs CTL 18.3 ± 0.6 nmol/mg, P = 0.02), myeloperoxidase activity(DMF 7.8 ± 0.4 m U/m L vs CTL 6.0 ± 0.5 m U/m L, P = 0.01) and level of endothelial nitric oxide synthase expression(DMF 0.38 ± 0.05-fold vs 0.17 ± 0.06-fold, P = 0.02). The higher expression levels of anti-oxidant enzymes(catalase and glutamatecysteine ligase modifier subunit and lower levels of key inflammatory mediators(nuclear factor-kappa B and cyclooxygenase-2 were confirmed in the DMF group.CONCLUSION DMF improved the liver function and the anti-oxidant and inflammation status following I/RI. Treatment with DMF could be a promising strategy in patients with liver I/RI.

The Electrocatalytic Activity of Bare Pyrolytic Graphite and Single Wall Carbon Nanotube Modified Glassy Carbon Sensors Is Same for the Quantification of Bisoprolol Fumarate

A comparison of voltammetric behavior of bisoprolol fumarate (BF) at edge and basal plane pyrolytic graphite electrodes (EPPGE/BPPGE) has been made with single wall carbon nanotube modified glassy carbon. The electrochemical properties are investigated exercising the cyclic voltammetry and square wave voltammetry (SWV). Enhanced peak current associated with bisoprolol fumarate oxidation at EPPGE is due to its better electron transfer property. Quantification of bisoprolol fumarate was carried out at pH 7.2 at both the pyrolytic graphite electrodes. Well-defined peak has been observed at ~ 792 and 954 mV at EPPGE and BPPGE respectively for bisoprolol fumarate oxidation. The detection limit is found to be 2.8 × 10–7 M and 7.3 × 10–7 M for EPPGE and BPPGE respectively. A comparison of common quantification parameters for bisoprolol at carbon nanotube modified glassy carbon electrode and bare BPPGE and EPPGE has been made and it is observed that carbon naotube modified glassy carbon exhibits sensitivity and detection limit close to that observed at bare basal plane pyrolytic graphite electrode. The method developed is applicable for determination of bisoprolol fumarate in pharmaceutical preparations and real samples.

Fumarate hydratase inactivation in renal tumors: HIF1α, NRF2, and "cryptic targets" of transcription factors

Biallelic inactivation of fumarate hydratase (FH) causes type 2 papillary renal cell carcinoma (PRCC2), uterine fibroids, and cutaneous leimyomas, a condition known as hereditary leiomyomatosis and renal cell cancer (HLRCC). The most direct effect of FH inactivation is intracellular fumarate accumulation. A majority of studies on FH inactivation over the past decade have focused on the theory that intracellular fumarate stabilizes hypoxia-inducible factor 1α (HIF1A) through competitive inhibition of HIF prolyl hydroxylases. Recently, a competing theory that intracellular fumarate activates nuclear factor (erythroid-derived 2)-like 2 (NRF2) through post-translational modification of its negative regulator. Kelch-like ECH-associated protein 1 (KEAP1) has emerged from a computational modeling study and mouse model studies. This review dissects the origin of these two governing theories and highlights the presence of chromatin-structure-regulated targets of transcription factors, which we refer to as "cryptic targets" of transcription factors. One such cryptic target is heme oxygenase I (HMOX1), the expression of which is known to be modulated by the gene product of SWI/SNF-related, matrix-associated, actin-dependent regulator of chromatin, subfamily a, member 4 (SMARCA4, also known as BRG1).

Effect of dimethyl fumarate on rats with chronic pancreatitis

Objective:To discuss the effect of dimethyl fumarate(DMF) on rats with L-arginine induced chronic pancreatitis(CP).Methods:Male Wistar rats were given DMF treatment(25 mg/kg) by oral lavage method;then Wistar rats were given the intraperitoneal injection of L-arginine for 5times(250 mg/100 kg,twice per time,each interval of 1 h) for building of CP model.Rats were divided into control group,CP group,DMF group and CP+DMF group.Rats in CP+DMF group were given the oral intragastric administration of DMF(25 mg/kg),while rats in control group and CP group were given the equal volume of normal saline.The weight of rats was evaluated and the intraperitoneal glucose tolerance test was performed(IPGTT,2 g/kg).The islet of rats was isolated and then flow cytometry was employed to evaluate the quality and activity of islets.Meanwhile,the histology of non-endocrine tissues and levels of myeloperoxidase(MPO) and malondialdchyde(MDA) were detected.Results:Compared with control group,the weight of rats in CP group was significantly reduced at week 2,4 and 6;the blood glucose significantly increased,AUC increased,the histopathological scores of pancreatic atrophy,acinar injury,edema and cellular infiltration increased,levels of MDA and MPO increased,the islet equivalent and islet activity decreased at 0.30,60,120 and 180 min.Compared with CP group,the weight of rats in CP+DMF group significantly increased at week 2,4 and 6;the blood glucose significantly decreased.AUC decreased,the histopathological scores of pancreatic atrophy,acinar injury,edema and cellular infiltration decreased,levels of MDA and MPO decreased,the islet equivalent and islet activity increased at 0,30.60,120 and 180 min.Conclusions:DMF treatment can improve CP induced by L-argininc and islet function in rats.

Effects of Ferrous Fumarate on Growth Performance,Blood Biochemical Parameters and Trace Elements of Oncorhynchus mykiss

[ Objective] The study aimed to discuss the effects of ferrous fumarate on growth performance, blood biochemical parameters and content of trace element of Oncorhynchus mykiss. [ Method ] Juvenile rainbow trout with an initial weight of （89.2 ±0.2） g were fed with the basal fodder supplemented with different levels of ferrous fumarate （0, 20, 40, 80,160 and 480 mg/kg iron） for 60 d, and the six groups were named DO, D20, D40, D80, D160 and D480, wherein DO was as the control group, actually containing 62.60, 79.50, 99.60, 139.30, 215.20 and 538.40 mg/kg iron respectively. [ Result] The growth performance of juvenile rainbow trout was not affected by different dietary iron levels obviously （ P 〉 0.05）. With the increase of dietary iron level, hemoglobin （Hb） content and number of red blood cells（RBC） rose firstly and then leveled off. No significance was found in hematocrit （Hct） among the six groups （P 〉0.05）. Iron content in the whole body, vertebrae and muscle increased significantly with the improvement of dietary iron level（ P 〈0.05）, and iron concentration in the liver increased firstly and then leveled off in groups from D40 to D480. No significant difference in zinc content of the whole body was found among the six groups （ P〉0.05）, while zinc content in the vertebrae and muscle in control group was significantly higher than that of other groups （ P〈0.05）, and zinc concentration in the liver in groups DO and 1320 was significantly higher than that of other groups （ P 〈0.05）. Copper content in the whole body increased significantly with the increase of dietary iron level （P 〈 0.05 ）, while no significant difference was observed in the vertebrae （ P 〉0.05）, and copper concentration in the muscle in control group was significantly lower than that of other groups （ P 〈0.05）. Serum lysozyme （LZM） activity of group DO was significantly lower than that of other groups （ P 〈 0.05） except for group D480 （ P 〉 0.05）. Catalase （CAT） activity of serum enhanced significantly （ P 〈 0.05） from DO to EH0 and then decreased obviously （P 〈0.05）. [ Conclusion] Based on hemoglobin and iron content in the liver, the broken-line model analysis showed that the dietary iron level provided by ferrous fumarate for juvenile rainbow trout was estimated to be 99.8 and 100.4 mg/kg respectively in the experiment.

Aqueous Diels-Alder Reactions of Cyclopentadicnc with Symmetric Diester of Fumarate or Maleate

Symmetric, diesters of cis- or trans- bicyclo[2,2,1]hept-5-ene-2,3-dicarboxylate were prepared by aqueous Diels-Alder reaction of cyclopentadiene with symmetric diester of fumarate or maleate.

Determination of Bisoprolol Fumarate by Fluorescence Quenching Method

[Objectives]To establish a new method for indirect determination of bisoprolol fumarate based on fluorescence quenching technology.[Methods]In ammonia water and ammonium chloride buffer solution at pH=9.2,whenλexcitation=277 nm andλemission=596 nm,with the increase of CCu2+,the fluorescence signal intensity of bisoprolol fumarate weakened,and the difference between the fluorescence intensity of bisoprolol fumarate itself and the fluorescence intensity of the test solution after the quencher Cu2+was added(ΔF)and Cbisoprolol fumarate showed a good linear relationship.[Results]In the range of 15.39-76.93μg/mL,ΔF=146.7 Cbisoprolol fumarate+482.1,r=0.9988,and the detection limit is 0.1391μg/mL.[Conclusions]The fluorescence quenching method has been applied to the determination of actual samples with a recovery rate of 99.9%and an RSD of 2.7%.The results are satisfactory.

Synthesis, Characterization and in vitro Degradation Properties of Poly(Propylene Fumarate-co-Propylene Sebacate) Networks

Poly(propylene fumarate-co-propylene sebacate) (P(PF-co-PS)) was crosslinked with N-vinyl pyrrolidone (N-VP) to form networks. It was investigated as biodegradable bone cement. In this paper, P(PF-co-PS) was synthesized and characterized by1 H-NMR, FTIR and GPC. The effects of the amount of sebacate segments in P(PF-co-PS) main chains and the quantity of N-vinyl pyrrolidone on the in vitro degradation of the polymer networks were examined. Cylindrical specimens were submerged in phosphate buffered saline (PBS) at 37 ℃ and the pH value of PBS is 7.4 for 10 weeks. The gravimetry and compressive mechanical properties were tested over the degradation period. Networks formed by P(PF-co-PS)8020/N-VP exhibited higher weight loss and better mechanical properties when compared with poly(propylene fumarate)/N-VP networks. The mechanical properties of P(PF-co-PS)/N-VP can be maintained for a very long time, even for 70 days, the yield strength, fracture strength and compressive modulus are (51.78 ± 2.01) MPa, (52.331 ± 1.84) MPa and (957.78 ± 24.40) MPa, respectively. The results demonstrate that the compressive mechanical properties and degradation velocity can be modulated by the amount of crosslinking agents and sebacate segments along the main chains of copolymers.

Pre-Formulation Development of Lamivudine 300 mg and Tenofovir Disoproxil Fumarate (TDF) 300 mg Fixed Dose Combination Tablets

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-1 (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.

Protective effect and mechanism of clemastine fumarate on acute lung injury in mice with intestinal ischemia-reperfusion

Objective:To evaluate the protective effect and mechanism of clemastine fumarate(CLE)on acute lung injury(ALI)in intestinal ischemia-reperfusion(I/R)mice.Methods:Twenty-four SPF Balb/c mice were randomly divided into sham operation group(sham group),ischemia-reperfusion group(I/R group),and clemastine fumarate pretreatment group(I/R+C group).In the I/R group,an intestinal ischemia-reperfusion model was established(ischemia for 40 minutes,reperfusion for 2 hours).In the I/R+C group,CLE 5 mg/kg was intraperitoneally injected before the operation.Lung tissue morphology was observed and scored by HE staining;and the ratios of wet weight to dry weight(W/D)were recorded.the levels of MDA,SOD,GSH-px,NF-κB and TNF-αin lung tissue of each group were determined by ELISA;Western blot method was used to determine the expression of TLR4 protein in lung tissue.Results:Compared with the Sham group,the I/R group had significantly higher lung tissue injury score and wet/dry ratio(P<0.05),increased lung tissue MDA level(P<0.05),decreased SOD and GSH-px levels(P<0.05),and increased NF-κB and TNF-αlevels,the expression of TLR4 protein in lung tissue increased(P<0.05);compared with the I/R group,the lung tissue injury score and wet/dry ratio of the I/R+C group decreased(P<0.05),the level of MDA in lung tissue decreased(P<0.05),the levels of SOD and GSH-px increased(P<0.05),and the levels of NF-κB and TNF-毩decreased(P<0.05),the expression of TLR4 protein in lung tissue decreased(P<0.05).Conclusion:Clemastine fumarate can alleviate acute lung injury after intestinal ischemia-reperfusion in mice,and the mechanism may be related to the inhibition of oxidative stress and inflammatory response in lung tissue.

Treatment of Chronic Hepatitis B with Tenofovir Disoproxil Fumarate in Ivory Coast

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.

欧洲药品评审局批准Aclidinium Bromide—Formoterol Fumarate Dihydrate复方制剂上市

欧洲药品评审局（EMA）于2014年11月19Et批准艾美罗（Almirall）公司的Aclidinium Bromide-Formoterol Fumarate Dihydrate（参考译名：阿地溴铵一富马酸福莫特罗，商品名：Duaklir Genuair、Brimica Genuair）粉雾剂上市，作为成人慢性阻塞性肺疾病（COPD）的维持治疗。

改性松浦支渠疏浚底泥吸附重金属离子的研究

中国河流每年产生大量的疏浚底泥,大量堆积不仅占用土地资源,而且对环境还有很大的影响。底泥的二次利用显得尤为重要,基于以废制废的原则,提高底泥资源化利用的价值,以松花江松浦支渠疏浚底泥为目标,对其进行资源利用。首先以丙烯酸、富马酸为原料,以过硫酸铵为引发剂制备聚AA-FA,以磷酸氢二钠中和制得聚AA-FA磷酸盐。利用聚AA-FA磷酸盐对热解的疏浚底泥进行改性,制备得到聚AA-FA改性松浦支渠疏浚底泥。研究发现聚AA-FA改性松浦支渠疏浚底泥对于重金属离子具有较强的吸附作用。在添加量质量分数为9%时脱除离子的能力最高可达到99%,脱除不同离子的能力由大到小顺序为Ni^(2+)、Pb^(2+)、Cr^(3+)。

阿托伐他汀钙片联合布地奈德福莫特罗吸入粉雾剂治疗慢性阻塞性肺疾病的临床疗效及对患者血气分析指标的影响

目的:探讨阿托伐他汀钙片联合布地奈德福莫特罗吸入粉雾剂治疗慢性阻塞性肺疾病(COPD)患者的临床疗效,及对患者血气分析指标的影响。方法:选取2021年12月~2023年12月期间某院收治的120例COPD患者作为研究对象,按照随机数字表法分为对照组和观察组,每组60例。对照组患者给予布地奈德福莫特罗吸入粉雾剂(Ⅱ)治疗,观察组在对照组治疗基础上加用阿托伐他汀钙片,两组均连续治疗4周。比较两组患者临床疗效、肺功能[用力肺活量(FVC)、呼气流量峰值(PEF)和第1秒用力呼气容积/用力肺活量(FEV1/FVC)]、血气分析指标[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))和血氧饱和度(SO_(2))]、辅助性T细胞1/辅助性T细胞2(Th1/Th2)、辅助性T细胞17/调节性T细胞(Th17/Treg)及不良反应发生情况。结果:治疗后,观察组患者治疗总有效率(93.33%)高于对照组(75.00%,P<0.05)。两组患者FVC、PEF及FEV1/FVC均升高(P<0.05),且观察组高于对照组(P<0.05);两组患者PaO_(2)、SO_(2)均升高(P<0.05),且观察组高于对照组(P<0.05);两组患者PaCO_(2)均降低(P<0.05),且观察组低于对照组(P<0.05);两组患者Th1/Th2和Th17/Treg均降低(P<0.05),且观察组低于对照组(P<0.05)。两组患者不良反应总发生率比较无统计学差异(P>0.05)。结论:与单用布地奈德福莫特罗吸入粉雾剂相比,阿托伐他汀钙片联合布地奈德福莫特罗吸入粉雾剂治疗COPD的临床疗效更佳,可有效改善患者肺功能、血气分析指标,且未增加不良反应的发生风险。

富马酸卢帕他定片治疗慢性荨麻疹的临床疗效及安全性研究

观察富马酸卢帕他定片治疗慢性荨麻疹的临床疗效及安全性。选取2021年7月—2023年7月医院收治的90例慢性荨麻疹患者为研究对象,随机将患者分为对照组和试验组两组,每组各45例。对照组患者接受左西利替嗪治疗,试验组患者接受富马酸卢帕他定片治疗,比较两组患者治疗效果。结果显示,试验组治疗总有效率高于对照组(P<0.05),不良反应总发生率低于对照组(P<0.05);治疗后,试验组患者各项症状评分、炎症因子指标和免疫指标均优于对照组(P<0.05);治疗3个月后,试验组患者的疾病复发率低于对照组(P<0.05)。研究发现,富马酸卢帕他定片治疗慢性荨麻疹患者效果显著,其能明显改善患者免疫功能,减轻患者体内的炎症反应,缓解患者的临床症状,治疗安全性较高。

三种代谢产物对老年急性心肌梗死患者发生肾损伤的预测价值

目的探讨老年急性心肌梗死(AMI)患者入院时血浆葡萄糖酸、富马酸和假尿苷联合预测急性肾损伤(AKI)的价值。方法收集2021年12月至2022年7月中国医学科学院阜外医院急诊科转入冠心病重症监护室治疗的老年AMI患者78例,根据住院期间AKI发生情况分为AKI组40例和非AKI组38例。采用液相色谱串联质谱定量分析AMI患者入院时血浆葡萄糖酸、富马酸和假尿苷水平。采用ROC曲线下面积(AUC)确定3种血浆代谢产物预测AMI患者发生AKI的价值。采用多因素logistic回归分析AKI的临床危险因素。结果AKI组与非AKI组血浆葡萄糖酸、富马酸和假尿苷水平比较,差异无统计学意义(P>0.05)。ROC曲线分析显示,葡萄糖酸、富马酸和假尿苷对老年AMI患者AKI发生无预测价值(AUC=0.576,95%CI:0.449~0.704,P=0.246;AUC=0.595,95%CI:0.467~0.721,P=0.154;AUC=0.563,95%CI:0.435~0.692,P=0.337)。多因素logistic回归分析显示,左心室射血分数(LVEF)是老年AMI患者发生AKI的独立预测因素(OR=0.923,95%CI:0.870~0.978,P=0.007)。结论老年AMI患者血浆葡萄糖酸、富马酸和假尿苷不能早期预测AKI发生,而LVEF是老年AMI患者发生AKI的独立预测因素。

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

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。