替诺福韦与恩替卡韦治疗慢性乙型肝炎的效果及其对早期肾功能的影响
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摘要
目的探讨替诺福韦与恩替卡韦治疗慢性乙型肝炎的效果及其对早期肾功能的影响。方法将120例慢性乙型肝炎患者随机分为对照组(n=60,恩替卡韦)与观察组(n=60,替诺福韦)。比较两组不同时间HBV DNA、β2-微球蛋白、视黄醇结合蛋白及胱抑素C水平。结果治疗前和治疗6、12、18个月时,两组血清HBV DNA水平无显著差异(P>0.05);治疗24个月时,对照组和观察组的HBV DNA转阴率比较,差异无统计学意义(P>0.05)。治疗6、12、18及24个月时,观察组β2-微球蛋白水平显著高于对照组(P<0.05),两组视黄醇结合蛋白及胱抑素C水平均无显著差异(P>0.05)。结论替诺福韦治疗慢性乙型肝炎的效果与恩替卡韦相当,但会对患者肾功能造成一定程度损伤,在治疗过程中可通过β2-微球蛋白评估患者肾功能。
Objective To investigate the effect of tenofovir and entecavir in the treatment of chronic hepatitis B and the influence on early renal function. Methods A total of 120 patients with chronic hepatitis B were randomly divided into control group(n=60, entecavir) and observation group(n=60, tenofovir). The levels of HBV DNA, β2 microglobulin, retinol binding protein and cystatin C were compared between the two groups at different time points. Results There were no significant differences in serum HBV DNA levels between the two groups before treatment and at 6, 12 and 18 months after treatment(P>0.05). At 24 months after treatment, there was no significant difference in the negative conversion rate of HBV DNA between the two groups(P>0.05). At 6, 12, 18 and 24 months after treatment, the level of β2-microglobulin in the observation group was significantly higher than that in the control group(P <0.05), and there were no significant differences in the levels of retinol binding protein and cystatin C between the two groups(P>0.05). Conclusion Tenofovir has the same effect as entecavir in the treatment of chronic hepatitis B, but it can cause some damage to the renal function of patients. In the course of treatment, the renal function of patients can be evaluated by β2-microglobulin.
Objective To investigate the effect of tenofovir and entecavir in the treatment of chronic hepatitis B and the influence on early renal function. Methods A total of 120 patients with chronic hepatitis B were randomly divided into control group(n=60, entecavir) and observation group(n=60, tenofovir). The levels of HBV DNA, β2 microglobulin, retinol binding protein and cystatin C were compared between the two groups at different time points. Results There were no significant differences in serum HBV DNA levels between the two groups before treatment and at 6, 12 and 18 months after treatment(P>0.05). At 24 months after treatment, there was no significant difference in the negative conversion rate of HBV DNA between the two groups(P>0.05). At 6, 12, 18 and 24 months after treatment, the level of β2-microglobulin in the observation group was significantly higher than that in the control group(P <0.05), and there were no significant differences in the levels of retinol binding protein and cystatin C between the two groups(P>0.05). Conclusion Tenofovir has the same effect as entecavir in the treatment of chronic hepatitis B, but it can cause some damage to the renal function of patients. In the course of treatment, the renal function of patients can be evaluated by β2-microglobulin.
引文
[1]陈玉兰,刘洁,陈立宇.三种核苷类似物对慢性乙型肝炎患者肾功能影响的长期随访研究[J].解放军医药杂志,2016,28(6):83-86.
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[4]朱习海,魏立平,季爱华,等.视黄醇结合蛋白与β_2-微球蛋白对老年患者早期肾脏损伤监测的意义[J].国际检验医学杂志,2016,37(4):533-534.
[5]袁育林,农生洲.尿视黄醇结合蛋白对早期肾功能损伤的诊断价值[J].中国医学创新,2013,10(16):162-164.
[6]石祖亮,王维鹏,叶涛,等.血清光抑素C及β2微球蛋白在妊娠期糖尿病患者肾功能评价中的临床意义[J].中国优生与遗传杂志,2016,24(4):72-73.
[2]徐勇,冯继红,李荣宽.阿德福韦酯联合其他核苷(酸)类似物治疗慢性乙型肝炎患者肾功能的变化[J].实用肝脏病杂志,2016,19(6):669-673.
[3]中华医学会肝病学分会.慢性乙型肝炎防治指南2010年更新版[J].中华实验和临床感染病杂志:电子版,2011,5(1):50-60.
[4]朱习海,魏立平,季爱华,等.视黄醇结合蛋白与β_2-微球蛋白对老年患者早期肾脏损伤监测的意义[J].国际检验医学杂志,2016,37(4):533-534.
[5]袁育林,农生洲.尿视黄醇结合蛋白对早期肾功能损伤的诊断价值[J].中国医学创新,2013,10(16):162-164.
[6]石祖亮,王维鹏,叶涛,等.血清光抑素C及β2微球蛋白在妊娠期糖尿病患者肾功能评价中的临床意义[J].中国优生与遗传杂志,2016,24(4):72-73.