药物不良反应杂志
藥物不良反應雜誌
약물불량반응잡지
ADVERSE DRUG REACTIONS JOURNAL
2014年
3期
163-167
,共5页
替诺福韦%药物毒性%肾%骨骼
替諾福韋%藥物毒性%腎%骨骼
체낙복위%약물독성%신%골격
Tenofovir%Drug toxicity%Kidney%Skeleton
替诺福韦是一种新型核苷酸类逆转录酶抑制剂，用于治疗HIV感染和慢性乙型肝炎。替诺福韦的潜在肾毒性与药物在肾脏排泄有关，病理改变表现为肾小管损害，临床表现为血磷降低和血清肌酸升高，还可导致Fanconi综合征、间质性肾炎和急性肾衰竭。替诺福韦的骨毒性是肾毒性的继发表现，临床表现为肌无力、骨痛和骨折。替诺福韦对肾脏-骨骼损害与基础疾病、基因多态性、血药浓度和药物相互作用有关。服用替诺福韦的患者应定期监测肾功能、电解质，低磷血症患者给予补磷治疗。肌酐清除率﹤50 ml/min的患者应调整替诺福韦的给药剂量。大部分患者在停用替诺福韦后肾功能会明显改善，部分患者可发展为慢性肾病。
替諾福韋是一種新型覈苷痠類逆轉錄酶抑製劑，用于治療HIV感染和慢性乙型肝炎。替諾福韋的潛在腎毒性與藥物在腎髒排洩有關，病理改變錶現為腎小管損害，臨床錶現為血燐降低和血清肌痠升高，還可導緻Fanconi綜閤徵、間質性腎炎和急性腎衰竭。替諾福韋的骨毒性是腎毒性的繼髮錶現，臨床錶現為肌無力、骨痛和骨摺。替諾福韋對腎髒-骨骼損害與基礎疾病、基因多態性、血藥濃度和藥物相互作用有關。服用替諾福韋的患者應定期鑑測腎功能、電解質，低燐血癥患者給予補燐治療。肌酐清除率﹤50 ml/min的患者應調整替諾福韋的給藥劑量。大部分患者在停用替諾福韋後腎功能會明顯改善，部分患者可髮展為慢性腎病。
체낙복위시일충신형핵감산류역전록매억제제，용우치료HIV감염화만성을형간염。체낙복위적잠재신독성여약물재신장배설유관，병리개변표현위신소관손해，림상표현위혈린강저화혈청기산승고，환가도치Fanconi종합정、간질성신염화급성신쇠갈。체낙복위적골독성시신독성적계발표현，림상표현위기무력、골통화골절。체낙복위대신장-골격손해여기출질병、기인다태성、혈약농도화약물상호작용유관。복용체낙복위적환자응정기감측신공능、전해질，저린혈증환자급여보린치료。기항청제솔﹤50 ml/min적환자응조정체낙복위적급약제량。대부분환자재정용체낙복위후신공능회명현개선，부분환자가발전위만성신병。
Tenofovir is a new class of nucleotide reverse transcriptase inhibitor with effective for treating HIV-infection and chronic hepatitis B. The potential renal toxicity of tenofovir is related to renal excretion. Renal histopathology revealed tubular injury. The main clinical manifestations of renal damage are decreased phosphorus and increased serum creatinine,and Fanconi syndrome,interstitial nephritis and acute renal failure may also develop. The bone toxicity of tenofovir is secondary to renal toxicity. The clinical manifestations include muscle weakness,bone pain and bone fracture. Tenofovir caused kidney-bone damage are associated with underlying diseases, gene polymorphism, plasma drug concentration and drug interactions. Patients taking tenofovir should be regularly monitored for renal function and electrolyte. The hypophosphatemia were treated with phosphate supplementation. The drug dosage should be adjusted when creatinine clearance rate is ﹤50 ml/min. Renal function was improved markedly after tenofovir withdrawal in some patients,but part of patients progressed to chronic kidney disease.
