富马酸替诺福韦二吡呋酯治疗慢性乙型肝炎60例

目的:观察富马酸替诺福韦二吡呋酯(TDF)治疗慢性乙型肝炎患者的临床疗效。方法:选取2018年1月至2020年6月在武汉市第七医院接受治疗的慢性乙型肝炎患者120例,随机分为2组,各60例。观察组患者服用TDF 300 mg/d,对照组患者服用恩替卡韦(ETV)0.5 mg/d,疗程均为12个月。比较两组患者治疗前后肝功能、病毒学应答变化情况以及TDF对肾功能的影响。结果:两组患者治疗后HBV DNA水平均较治疗前明显下降(P<0.05);治疗第12个月,TDF组HBV DNA水平低于ETV组(P<0.05),但两者HBV DNA转阴率差异无统计学意义(P>0.05);治疗6个月TDF组患者AST、ALT低于ETV组(P<0.05),治疗12个月尿α1-微球蛋白水平高于ETV组(P<0.05),两组血β2微球蛋白水平无明显改变(P>0.05)。结论:采用TDF治疗慢性乙型肝炎临床疗效显著,但在长期用药过程中有潜在肾损伤风险,应该积极检测肾功能。

Clinical analysis of tenofavir disoproxil fumarate in the treatment of patients with chronic hepatitis B

Objective:To observe the clinical efficacy of Tenofavir Disoproxil Fumarate(TDF)in the treatment of patients with chronic hepatitis B.Methods:A total of 120 patients with chronic hepatitis B who received treatment in Wuhan No.7 Hospital from January 2018 to June 2020 were randomly divided into 2 groups and 60 patients in each group.The patients in the observation group were treated with tenofovir(TDF)and the patients in the control group were treated with entecavir(ETV).Both groups were treated for 12 months.The changes of liver function,virological response and the effect of TDF on renal function were compared between the two groups before and after treatment.Results:The HBV DNA level of the two groups after treatment was significantly lower than that before treatment(P<0.05);At the 12th month after treatment,the HBV DNA level in TDF group was significantly lower than that in ETV group(P<0.05),but there was no significant difference in HBV DNA negative conversion rate between TDF group and ETV group(P>0.05);At the 6th month of treatment,AST and ALT in TDF group were lower than those in ETV group(P<0.05);The level of the urinaryα1 microglobulin abnormal was higher than that in ETV group at the 12th month of treatment(P<0.05),There was no significant change in the level of bloomβ2 microglobulinin both groups(P>0.05).Conclusion:Antiviral therapy with tenofovir is clinically significant,but there is a potential risk of renal injury in the process of long-term medication.We should actively detect the changes of renal function.