摘要
目的:探讨长期服用核苷酸类药物致肾损伤的慢性乙型肝炎与患者尿神经导向因子(Netrin)-1及肾损伤因子(KIM)-1水平的关系。方法:随机选取我院诊治的47例长期服用核苷酸类药物的慢性乙型肝炎患者作为观察组,另选取同期于我院诊治未应用核苷酸类药物进行抗病毒治疗的53例患者作为对照组。对患者进行随访调查,观察两组的尿Netrin-1、KIM-1、血清尿素氮、血清肌酐、肾小球滤过率等变化情况。结果:阿德福韦酯以及替诺福韦酯治疗的患者在长期用药下出现明显肾损伤,出现肾损伤患者Netrin-1、KIM-1均明显高于对照组,且随着肾损伤的加重,Netrin-1、KIM-1水平均明显上升(P <0. 05)。经过多因素回归分析,Netrin-1、KIM-1与肾损伤呈正相关。结论:尿Netrin-1、KIM-1水平随着肾损伤的加重明显上升,在多因素分析下其与肾损伤呈正相关的关系。
Objective: To discuss the relationship between chronic hepatitis B of kidney injury caused by longterm use of nucleotide drugs and urinary neuronal guidance factor(Netrin)-1,urinary kidney injury molecule(KIM)-1 levels. Methods: Forty-seven patients with chronic hepatitis B who had been taking nucleotides for a long time were randomly selected as the observation group. In addition,53 patients who were treated with anti-viral therapy without nucleotide drugs in our hospital were selected as the control group. The patients were followed up and the changes of urine Netrin-1,KIM-1,serum urea nitrogen,serum creatinine and glomerular filtration rate were observed in the two groups. Results: Patients treated with adefovir dipivoxil and tenofovir disoproxil showed significant renal injury under long-term use. Netrin-1 and KIM-1 levels of patients with renal injury in the observation group were significantly higher than those in the control group. With the severity of renal injury,Netrin-1,KIM-1 levels were significantly increased( P < 0. 05). After multivariate regression analysis,Netrin-1 and KIM-1 levels were positively correlated with renal injury. Conclusion: The urinary Netrin-1 and KIM-1 levels show significant increase with the severity of renal injury. Under multivariate analysis,it was positively correlated with renal injury.
引文
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