摘要
目的了解阿德福韦酯（ADV）单药或联合用药治疗慢性乙型肝炎（CHB）患者对尿β2-微球蛋白（β2-MG）的影响，为评估肾小管功能提供依据，为临床用药提供参考。方法单用或联合使用ADV治疗的CHB患者234例，检测尿B2-MG，分析其与用药时间、治疗方案、年龄、性别等因素之间的关系。结果随着用药时间的延长，尿β2-MG异常比例和严重程度逐年增加，各时间段比较差异无统计学意义（P〉0．05）。ADV单用或联合拉米夫定（LAM）或恩替卡韦（ETV）使用时，引起尿β2-MG异常之间差异无统计学意义（P〉0．05），但是与替比夫定（LdT）联合使用时，引起尿B2-MG异常比例与其它治疗方案之间差异有统计学意义（P〈0．05）。尿p2-MG异常与年龄之间不存在相关性（OR=0．996，P〉0．05），但是与性剐、用药时间均有相关性（P〈0．05），各组治疗方案的疗程差异无统计学意义（P〉0．05）。结论ADV单药或联合LAM或ETV用药时可引起尿B2-MG异常，与LdT联合使用时，β2-MG异常发生的可能性变小。男性患者、用药时间较长者更容易出现尿B2-MG异常。
Objective To analyze the changes of urinary β 2- microglobulin.ofpatients with chronic hepatitis b who received adefovir dipivoxil alone or with other antivirals therapy and provide a basis for assessing renal tubular function, and then provide a reference for clinical practice. Methods Data of 234 patients with chronic hepatitis b who received adefovir dipivoxil alone or with other antivirals therapy in outpatient follow- up of liver disease of our hospital were collected. Their urinary β2-microglobulin and analyze the correlation between urinary β2- microglobulin and treatment time programs were detected, the patient＇ s age, gender and so on. Results With the extension of treatment time, the proportion of abnormal changes of urine β2- microglobulin increased. The difference was no statistically significant （ P〉0.05 ） . There was no significant difference about the changes in urine β2- mieroglobulin caused by adefovir dipivoxil alone or combination with lamivudine or entecavir （ P〉0.05 ） , but the difference was statistically when compared with adefovir combination with telbivudine （ P〈0.05 ） .There was also no correlation between age and the changes in urine β2- microglobulin （ OR=0.996, P〉0.05 ） , But it was associated with gender and course of treatment （ P〈0.05 ） . No statistical differences between groups of treatment （ P〉0.05 ） . Conclusion ADV alone or with lamivudine or entecavir cause gradual increase in the proportion of urine β2-microglobulin abnormal. Urinary β2 microglobulin abnormalities show a lower incidence when using adefovir combination with telbivudine. Male patients and longer time treatment are more prone to arise abnormal in urine β2- microglobulin.
出处
《浙江临床医学》
2016年第2期253-255,共3页
Zhejiang Clinical Medical Journal
