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阿德福韦酯治疗乙型肝炎肝硬化合并乙型肝炎病毒相关性肾炎的近期疗效
引用本文:李东复,金珍婧,陈永胜,乔连铭,周键. 阿德福韦酯治疗乙型肝炎肝硬化合并乙型肝炎病毒相关性肾炎的近期疗效[J]. 中华肝脏病杂志, 2008, 16(5): 349-351
作者姓名:李东复  金珍婧  陈永胜  乔连铭  周键
作者单位:吉林大学第二医院消化内科,长春,130041
基金项目:吉林省科技发展计划项目 
摘    要:目的 观察阿德福韦酯治疗乙型肝炎肝硬化合并乙型肝炎病毒相关性肾炎的近期疗效.方法 选择6例乙型肝炎肝硬化合并乙型肝炎病毒相关性肾炎患者,定量PCR测得血清HBVDNA>105拷贝/ml,肾组织HBV DNA阳性,肝功能Child-Pugh分级均为A级,在常规治疗基础上加用阿德福韦酯10 mg/d 1年.于治疗后1、3、6个月复查血常规、尿蛋白定量、肝肾功能、血清HBV标志物变化情况.结果 治疗后3、6个月血清HBV DNA转阴的分别有2例和5例,HBeAg转阴的分别有1例和4例,抗HBe转阳的均只有1例;ALT复常的分别有5例和6例,总胆红素复常的分别有4例和5例.治疗6个月后尿蛋白量<0.3 g/d的2例,尿蛋白量较治疗前下降>50%的3例.巩固治疗1年时完全缓解3例,部分缓解2例. 结论 阿德福韦酯治疗乙型肝炎肝硬化合并乙型肝炎病毒相关性肾炎近期安全有效.

关 键 词:肝炎病毒,乙型  肝硬化  肾炎  阿德福韦酯

Adefovir dipivoxil treatment of hepatic cirrhosis complicated with hepatitis B virus associated glomerulonephritis
LI Dong-fu,JIN Zhen-jing,CHEN Yong-sheng,QIAO Lian-ming,ZHOU Jian. Adefovir dipivoxil treatment of hepatic cirrhosis complicated with hepatitis B virus associated glomerulonephritis[J]. Chinese journal of hepatology, 2008, 16(5): 349-351
Authors:LI Dong-fu  JIN Zhen-jing  CHEN Yong-sheng  QIAO Lian-ming  ZHOU Jian
Affiliation:Department of Digestive Diseases, Second Hospital, Jilin University, Changchun 130041, China. ldf908@sina.com
Abstract:OBJECTIVE: To investigate the efficacy and safety of adefovir dipivoxil (ADV) in treating hepatic cirrhosis complicated with hepatitis B virus associated glomerulonephritis. METHODS: Six hepatic cirrhosis (Child-Pugh A grade, liver function compensated) patients complicated with hepatitis B virus associated glomerulonephritis diagnosed by renal biopsy, real time PCR and urinary protein tests were treated with ADV for one year in addition to a routine treatment. The dosage of ADV was 100mg daily. RESULTS: After 3 and 6 months treatment the negative conversion rates of HBV-DNA were 33.3% and 83.3%; the negative conversion rates of HBeAg were 16.7% and 66.7%; the positive conversion rates of HBeAb were both 16.7%; the recovery rates of ALT were 83.3% and 100.0%; and the recovery rates of TBil were 66.7% and 83.3% respectively. Protein in the urine of two patients was decreased to 0.3 g/d and in three patients it was 50% of the original values. After 1 year treatment the disease subsided fully in 3 and partially in 2 patients. CONCLUSION: Treating hepatic cirrhosis complicated with hepatitis B virus associated glomerulonephritis using adefovir dipivoxil is effective and safe.
Keywords:Hepatitis B virus  Liver cirrhosis  Nephritis  Adefovir dipivoxil
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