CAJ | 학술논문

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.
목적 관찰아덕복위지치료을형간염간경화합병을형간염병독상관성신염적근기료효.방법 선택6례을형간염간경화합병을형간염병독상관성신염환자,정량PCR측득혈청HBVDNA＞105고패/ml,신조직HBV DNA양성,간공능Child-Pugh분급균위A급,재상규치료기출상가용아덕복위지10 mg/d 1년.우치료후1、3、6개월복사혈상규、뇨단백정량、간신공능、혈청HBV표지물변화정황.결과 치료후3、6개월혈청HBV DNA전음적분별유2례화5례,HBeAg전음적분별유1례화4례,항HBe전양적균지유1례;ALT복상적분별유5례화6례,총담홍소복상적분별유4례화5례.치료6개월후뇨단백량＜0.3 g/d적2례,뇨단백량교치료전하강＞50%적3례.공고치료1년시완전완해3례,부분완해2례. 결론 아덕복위지치료을형간염간경화합병을형간염병독상관성신염근기안전유효.
Objective To investigate the efficacy and safety of adefovir dipivoxil(ADV)in Weating 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.