摘要
目的分析基于索非布韦的口服直接作用抗病毒药物治疗终末期肾病合并丙型肝炎病毒感染的血液透析患者的疗效以及安全性。方法选择2018年5月—2020年2月于山东省济南市中心医院进行治疗的终末期肾病合并丙型肝炎病毒感染的血液透析患者6例,所有患者均服用索非布韦与达拉他韦进行治疗,6例患者中,失代偿期肝硬化的有1例,代偿期肝硬化为1例,慢性丙型肝炎4例,其中失代偿期肝硬化患者需治疗24周,其他患者治疗12周。观察所有患者的治疗有效性以及安全性。结果随访结果显示,6例患者都获得了快速病毒学应答,没有病毒学突破,也不存在终末期肾病合并丙型肝炎病毒感染的情况。口服直接作用抗病毒药物治疗过程中,6例患者血小板、尿素清除指数、白细胞、尿素下降率以及血红蛋白和治疗之前无差异,肝功能正常。经治疗,只有1例患者发生不良反应,不良反应发生的几率为16.67%。该例患者的不良反应未经过特殊处理便自行好转。结论对终末期肾病合并丙型肝炎病毒感染的血液透析患者采用索非布韦与达拉他韦进行治疗,治疗效果和安全性极好,可在临床推广使用。
Objective To analyze the efficacy and safety of sofosbuvir-based oral direct-acting antiviral drugs for hemodialysis patients with end-stage renal disease and hepatitis C virus infection.Methods 6 hemodialysis patients with endstage renal disease and hepatitis C virus infection who were treated in the hospital from May 2018 to February 2020 were selected.All patients were treated with sofosbuvir and dalatavir.Among the 6 patients,1 had decompensated cirrhosis,1 had compensated cirrhosis,and 4 had chronic hepatitis C.Among them,patients with decompensated cirrhosis needed treatment for 24 weeks,and other patients had 12 weeks of treatment.After treatment,the treatment effectiveness and safety of all patients were observed.Results The follow-up results showed that all 6 patients obtained rapid virological response,no virological breakthrough,and no end-stage renal disease complicated with hepatitis C virus infection.During the course of oral direct-acting antiviral treatment,6 patients had no difference in the reduction rate of platelet,urea clearance index,white blood cell,urea,and hemoglobin from before treatment,and liver function was normal.After treatment,only 1 patient had an adverse reaction,and the probability of an adverse reaction was 16.67%.The adverse reaction of this patient improved spontaneously without special treatment.Conclusion Sofosbuvir and dalatavir are used for hemodialysis patients with end-stage renaldisease combined with hepatitis C virus infection.The therapeutic effect and safety are excellent,and it can be used in clinical promotion.
作者
张慧丽
王嫣然
吴春玲
任万军
ZHANG Huili;WANG Yanran;WU Chunling;REN Wanjun(Shandong First Medical University(Shandong Academy of Medical Sciences),Jinan 250117,China;Department of Nephrology/Blood Purification,Central Hospital Affiliated to Shandong First Medical University,Jinan 250013,China)
出处
《中国全科医学》
CAS
北大核心
2020年第S02期130-132,共3页
Chinese General Practice
