CAJ | 학술논문

目的：了解低剂量阿德福韦酯致低血磷骨软化症的临床特征及预防、治疗措施。方法通过检索Pubmed、中国生物医学文献服务系统和中国知网2002年1月1日~2014年12月31日的数据，汇总有关阿德福韦酯致低磷血症的病例报道数据进行分析。结果共检索到相关文献39篇，硕士研究生毕业论文1篇，获得病例71例。患者均有乙肝病史并长期服用阿德福韦酯，出现不良反应后病程进展缓慢，以骨痛为主要临床表现，严重者出现行走障碍、肌肉萎缩等。实验室检查伴有血磷降低、血清碱性磷酸酶活性升高，影像学检查有不同程度的骨损害。患者在采取治疗措施之后，症状均得到不同程度的缓解。结论长期应用低剂量阿德福韦酯治疗慢性乙型肝炎，可能引起低磷性骨软化症，需加强临床用药监测，检查血磷等水平以及影像学检查可作为发现阿德福韦酯引发低血磷性骨损害的有效手段，如出现不良反应应及时采取有效治疗措施。
목적：료해저제량아덕복위지치저혈린골연화증적림상특정급예방、치료조시。방법통과검색Pubmed、중국생물의학문헌복무계통화중국지망2002년1월1일~2014년12월31일적수거，회총유관아덕복위지치저린혈증적병례보도수거진행분석。결과공검색도상관문헌39편，석사연구생필업논문1편，획득병례71례。환자균유을간병사병장기복용아덕복위지，출현불량반응후병정진전완만，이골통위주요림상표현，엄중자출현행주장애、기육위축등。실험실검사반유혈린강저、혈청감성린산매활성승고，영상학검사유불동정도적골손해。환자재채취치료조시지후，증상균득도불동정도적완해。결론장기응용저제량아덕복위지치료만성을형간염，가능인기저린성골연화증，수가강림상용약감측，검사혈린등수평이급영상학검사가작위발현아덕복위지인발저혈린성골손해적유효수단，여출현불량반응응급시채취유효치료조시。
s: Objective To master hypophosphatemia osteomalacia's clinical characteristics which caused by low-dose adefovir dipivoxil, and find the prevention and treatment measures. Methods By searching the data of Pubmed, Chinese Biomedical Literature Service System and China Category (January 1st, 2002~December 31st, 2014), the data of hypophosphatemia reported in cases caused by adefovir was summarized and analyzed. Results A total of 39 relevant documents and one graduate thesis were retrieved, including 71 cases. All of the patients have a history of hepatitis B disease and a long-term use of adefovir dipivoxil.With slow progression of adverse reactions, the main clinical manifestations are skeletal pain. Some patients experienced serious adverse reactions, such as walking disorders and muscle atrophy. Laboratory tests appeared to reduced phosphorus levels and elevated serum alkaline phosphatase activi-ty. Imaging studies showed different degrees of skeletal damage. After being taken to the treatment, the patient's symp-toms were eased for varying degrees. Conclusion A long-term low-dose adefovir dipivoxil treatment of chronic hep-atitis B may cause phosphorus bone softening disease. Therefore, we need to strengthen the monitoring of clinical medicine, check the phosphorus levels, and imaging examination can be used as an effective means to find hypophos-phatemia bone damage caused by adefovir. If patients had adverse reactions effective treatment should be taken time-ly.