中华肝脏病杂志
中華肝髒病雜誌
중화간장병잡지
CHINESE JOURNAL OF HEPATOLOGY
2015年
8期
590-593
,共4页
宁会彬%李宽%李威%丁岗强%肖二辉%毛重山%康谊%尚佳
寧會彬%李寬%李威%丁崗彊%肖二輝%毛重山%康誼%尚佳
저회빈%리관%리위%정강강%초이휘%모중산%강의%상가
肝炎,乙型,慢性%治疗%阿德福韦酯%血磷代谢
肝炎,乙型,慢性%治療%阿德福韋酯%血燐代謝
간염,을형,만성%치료%아덕복위지%혈린대사
Hepatitis B,chronic%Therapy%Adfovir dipivoxil%Blood phosphorus metabolism
目的 探讨慢性乙型病毒性肝炎(CHB)患者应用阿德福韦酯(ADV)抗病毒治疗对血磷代谢的影响. 方法 对75例HBsAg阳性的CHB患者按照单用ADV、ADV联合干扰素(IFN)、ADV联合拉米夫定(LAM)分为三组,检测治疗过程中的4周、12周、24周、48周、72周、96周的血钙、血磷、血尿素氮、血肌酐水平.定量资料采用t检验,定性资料采用x2检验,影响因素分析采用单因素方差分析及非条件logistic回归分析,P＜0.05为差异有统计学意义. 结果 75例患者中治疗过程中发生低血磷者32例,占42.67％,血磷水平为(0.86±0.10) mmol/L,均为轻度低磷.单用ADV组、ADV联合IFN组及ADV联合LAM组患者低血磷的发生率均在治疗24周时最高,分别为25.0％,27.5％,36.4％,三组之间比较,P＞ 0.05,差异无统计学意义;三组患者的血磷水平比较,差异也无统计学意义(F=1.853,P=0.169).logistic回归分析显示:低磷的发生与性别(x2=7.876,P＜0.05)、年龄(t=-2.479,P＜0.05)和血肌酐水平(t=-2.256,P＜0.05)相关;而与患者血尿素氮、血钙水平无明显相关性(P＞0.05).结论 应用ADV抗病毒治疗的CHB患者随着用药时间的延长会出现不同程度的血磷降低,且低血磷的发生多为轻度,而ADV的不同治疗方案患者低血磷的发生率与发生程度差异无统计学意义.血肌酐水平的升高可以从一定程度上提示低血磷的发生,尤其是在男性、年长患者中应予重视.
目的 探討慢性乙型病毒性肝炎(CHB)患者應用阿德福韋酯(ADV)抗病毒治療對血燐代謝的影響. 方法 對75例HBsAg暘性的CHB患者按照單用ADV、ADV聯閤榦擾素(IFN)、ADV聯閤拉米伕定(LAM)分為三組,檢測治療過程中的4週、12週、24週、48週、72週、96週的血鈣、血燐、血尿素氮、血肌酐水平.定量資料採用t檢驗,定性資料採用x2檢驗,影響因素分析採用單因素方差分析及非條件logistic迴歸分析,P＜0.05為差異有統計學意義. 結果 75例患者中治療過程中髮生低血燐者32例,佔42.67％,血燐水平為(0.86±0.10) mmol/L,均為輕度低燐.單用ADV組、ADV聯閤IFN組及ADV聯閤LAM組患者低血燐的髮生率均在治療24週時最高,分彆為25.0％,27.5％,36.4％,三組之間比較,P＞ 0.05,差異無統計學意義;三組患者的血燐水平比較,差異也無統計學意義(F=1.853,P=0.169).logistic迴歸分析顯示:低燐的髮生與性彆(x2=7.876,P＜0.05)、年齡(t=-2.479,P＜0.05)和血肌酐水平(t=-2.256,P＜0.05)相關;而與患者血尿素氮、血鈣水平無明顯相關性(P＞0.05).結論 應用ADV抗病毒治療的CHB患者隨著用藥時間的延長會齣現不同程度的血燐降低,且低血燐的髮生多為輕度,而ADV的不同治療方案患者低血燐的髮生率與髮生程度差異無統計學意義.血肌酐水平的升高可以從一定程度上提示低血燐的髮生,尤其是在男性、年長患者中應予重視.
목적 탐토만성을형병독성간염(CHB)환자응용아덕복위지(ADV)항병독치료대혈린대사적영향. 방법 대75례HBsAg양성적CHB환자안조단용ADV、ADV연합간우소(IFN)、ADV연합랍미부정(LAM)분위삼조,검측치료과정중적4주、12주、24주、48주、72주、96주적혈개、혈린、혈뇨소담、혈기항수평.정량자료채용t검험,정성자료채용x2검험,영향인소분석채용단인소방차분석급비조건logistic회귀분석,P＜0.05위차이유통계학의의. 결과 75례환자중치료과정중발생저혈린자32례,점42.67％,혈린수평위(0.86±0.10) mmol/L,균위경도저린.단용ADV조、ADV연합IFN조급ADV연합LAM조환자저혈린적발생솔균재치료24주시최고,분별위25.0％,27.5％,36.4％,삼조지간비교,P＞ 0.05,차이무통계학의의;삼조환자적혈린수평비교,차이야무통계학의의(F=1.853,P=0.169).logistic회귀분석현시:저린적발생여성별(x2=7.876,P＜0.05)、년령(t=-2.479,P＜0.05)화혈기항수평(t=-2.256,P＜0.05)상관;이여환자혈뇨소담、혈개수평무명현상관성(P＞0.05).결론 응용ADV항병독치료적CHB환자수착용약시간적연장회출현불동정도적혈린강저,차저혈린적발생다위경도,이ADV적불동치료방안환자저혈린적발생솔여발생정도차이무통계학의의.혈기항수평적승고가이종일정정도상제시저혈린적발생,우기시재남성、년장환자중응여중시.
Objective To investigate the effects of adefovir dipivoxil (ADV) on blood phosphorus metabolism in patients with chronic hepatitis B (CHB).Methods Patients with hepatitis B surface antigen (HBsAg)-positive CHB were treated with ADV alone,ADV combined with interferon (IFN),or ADV combined with lamivudine (LAM).Changes in levels of calcium,phosphate,urea,and creatinine were assessed at treatment weeks 4,12,24,48,72 and 96.Statistical analysis was carried out with SPSS 16 software;influential factors were analyzed by ANOVA and non-conditional logistic regression analysis.Results During the course of treatments,32 (42.6％) of the patients presented with low phosphorus.The highest incidence of low phosphorus was found to have occurred at treatment week 24 (25.0％,27.5％ and 36.4％ respectively,with no statistical difference between three groups,x2 =0.225,P ＞ 0.225).Patients with hypophosphatemia did not show a significant difference in serum phosphorus levels from the other patients (F =1.853,P =0.169).Logistic regression showed a correlation between low phosphorus and sex (x2 =7.876,P ＜ 0.05),age (t =2.479,P ＜ 0.05),and serum creatinine (t =-2.256,P ＜ 0.05),but not with blood urea nitrogen or blood calcium (P ＞0.05).Conclusion ADV antiviral treatment can decrease the blood phosphorous levels of CHB patients,particularly over extended time of treatment,and the occurrence of low phosphorus is more common than of mild phosphorus decrease.Male and elderly patients may be at greater risk of this complication.The incidence and severity of low phosphorus is not significantly different for the different ADV-based treatment regimens.
