恩替卡韦对轻度肾功能损伤慢性乙型肝炎患者eGFR的影响被引量：7

The effects on e GFR of ETV treating CHB patients with mild renal function injury

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摘要目的分析恩替卡韦治疗期间病毒学应答对轻度肾功能损伤慢性乙型肝炎患者肾功能的影响。方法2011-2016年期间,于北京友谊医院门诊初治的慢性乙型肝炎患者,规律服用恩替卡韦治疗2年。观察治疗1年、2年的HBV DNA转阴率和估算肾小球滤过率（e GFR）。根据治疗1年时病毒水平分为应答组和应答不佳组（HBV DNA〉100 IU/ml）,比较两组的肌酐和e GFR水平。结果分别有59例和41例患者完成1年和2年治疗。治疗1年时HBV DNA转阴率为66.10%（39/59）,2年为75.61%（31/41）。所有患者基线e GFR为88.35±14.53 ml/（min·1.73 m^2）,治疗1年和2年后分别为93.37±33.94 ml/（min·1.73 m^2）和89.01±15.43 ml/（min·1.73 m^2）,与基线水平无显著差异（P〉0.05）。应答不佳与应答组的e GFR在基线及治疗1年和2年后e GFR分别为81.20±13.62 ml/（min·1.73m^2）、76.37±16.50 ml/（min·1.73 m^2）、83.91±13.71 ml/（min·1.73 m^2）和80.26±15.15 ml/（min·1.73 m^2）、80.49±15.73 ml/（min·1.73 m^2）、79.01±15.54 ml/（min·1.73 m^2）。治疗前后及两组间比较,均无显著差异（P〉0.05）。结论恩替卡韦治疗2年,对于轻度肾功能损伤慢性乙型肝炎患者的肾功能无显著影响,早期病毒学应答情况与肾功能改变无关。 Objective To assess renal function associated with entecavir （ ETV） treatment in chronic hepatitis B （ CHB） patients with mild renal function injury during the period of virological response. Methods The CHB patients received ETV antiviral treatment from 2011 to 2016 without interruption for at least two years. All patients were outpatients of Beijing Friendship Hospital, which located in Beijing, China. To observe the HBV DNA negative conversion and estimate the Glomerular filtration rate （ eGFR） after treatment for 1 or 2 years. The eligible patients comprised two groups who were divided into good response and poor response （poor virological responses are defined as HBV 〉 100 IU/ml） based on their virological response after treatment for 1 year. To compare the change of Cr and eGFR between the two group. Results T h e patients w h o had complete treatment for 1 and 2 years are 59 cases and 41 cases, respectively. The HBV DNA negative conversion after 1 year and 2 years are 66. 10% （39/59） and 75. 61% （31/41 ） , respectively. All patients with baseline eGFR values were 88. 35 ± 14. 53 ml/（min·1.73 m^2 ）,after treatment for 1 year and 2 year,the eGFR values were 93. 37 ± 33.94 ml/（min·1.73 m^2 ） and 89. 01 ± 15.43 ml/（min·1.73 m^2 ）,there are no significantly different compared with baseline eGFR （ P 〉 0 . 05）. A n d the eGFR in the two group are 8 1 . 2 0 ± 13. 6 2 ml/ （min·1.73 m^2） and 80. 26 ± 15. 15 ml/（ min·1.73 m^2 ） on baseline, 76. 37 ± 16.50 ml/（min·1.73 m^2） and 80.49 ± 15. 73 m l/（ min·1.73 m^2） after 1 year, 83.91±13.71 ml/（min·1.73 m^2） and 79.01±15.54ml/（min·1.73 m^2） after2year, respectively. Wefoundthat there are no significantly different between the two group before and after ETV treatment （ P 〉0. 05）. Conclusion ETV treatment for 2 year has no obvious influence on renal function in CHB patients with mild renal function injury, and early virological response has nothing to do with the change of the renal function.

作者何艳杰张程王宇崔巍

机构地区中国医科大学第一临床医院传染科首都医科大学附属北京友谊医院肝病中心

出处《临床和实验医学杂志》 2016年第18期1818-1821,共4页 Journal of Clinical and Experimental Medicine

关键词慢性乙型肝炎恩替卡韦病毒学应答肾功能 Chronic hepatitis B Entecavir Virological response Renal function

分类号 R512.62 [医药卫生—内科学]

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