摘要
目的分析应用艾米替诺福韦治疗慢性乙型肝炎(CHB)患者的疗效。方法2021年8月~2022年2月我院诊治的62例CHB患者,被随机分为A组和B组,每组31例,分别给予艾米替诺福韦或富马酸替诺福韦治疗,治疗观察48 w。采用实时荧光定量PCR法检测血清HBV DNA载量,采用化学发光免疫分析法检测血清HBsAg和HBeAg水平,使用肝脏瞬时弹性成像仪行肝脏硬度检测(LSM),常规检测血液和血清指标,计算肝纤维化4因子指数(FIB-4)和估算的肾小球滤过率(eGFR)。结果在治疗24 w时,A组血清ALT、AST水平和HBV DNA载量分别为(64.3±13.6)IU/L、(61.5±4.0)IU/L和(1.2±0.2)Ig IU/mL,在治疗48 w时,分别为(40.1±3.8)IU/L、(39.4±3.3)IU/L和(0.9±0.2)In IU/mL,与B组比,均无显著性差异【分别为(67.2±3.8)IU/L、(65.3±4.2)IU/L和(1.2±0.3)Ig IU/mL及(38.4±4.1)IU/L、(42.8±3.9)IU/L和(0.9±0.2)Ig IU/mL,P<0.05】;A组LSM、FIB-4和eGFR分别为(7.1±1.7)kPa、(2.0±0.4)和(101.3±7.9)mL/min/1.73 m^(2),及(7.2±1.5)kPa、(1.6±0.3)和(100.9±8.2)mL/min/1.73 m^(2),与B组【分别为(7.3±1.6)kPa、(2.2±0.5)和(95.6±8.0)mL/min/1.73 m^(2),及(7.1±1.6)kPa、(1.6±0.4)和(94.0±7.6)mL/min/1.73 m^(2)】比,仅eGFR存在显著性差异(P<0.05)。结论应用艾米替诺福韦治疗CHB患者疗效与富马酸替诺福韦治疗类似,但可能对肾功能的影响小,值得继续临床应用观察。
Objective The aim of this study was to compare the antiviral efficacy of tenofovir amibufenamide to tenofovir disoproxil fumarate(TDF)in the treatment of patients with chronic hepatitis B(CHB).Methods 62 patients with CHB were enrolled in our hospital between August 2021 and February 2022,and were randomly divided into group A and group B,with 31 cases in each group,receiving tenofovir amibufenamide or TDF for 48 weeks.Serum HBV DNA loads were detected by real-time fluorescence quantitative PCR,serum HBsAg and HBeAg levels were detected by ELISA,and blood routine and serum alanine aminotransferase(ALT)and aspartate aminotransferase(AST)levels were obtained to calculate fibrosis index based on 4 factor(FIB-4)and estimated glomerular filtration rate(eGFR).The liver stiffness measurement(LSM)was determined by liver transient elastography.Results At 24 weeks of treatment,serum ALT,AST levels and serum HBV DNA load in group A were(64.3±13.6)IU/L,(61.5±4.0)IU/L and(1.2±0.2)Ig IU/mL,and at the end of 48 week treatment,they were(40.1±3.8)IU/L,(39.4±3.3)IU/L and(0.9±0.2)In IU/mL,all not significantly different compared to[(67.2±3.8)IU/L,(65.3±4.2)IU/L and(1.2±0.3)Ig IU/mL,and(38.4±4.1)IU/L,(42.8±3.9)IU/L and(0.9±0.2)Ig IU/mL,respectively,P<0.05]in group B;the LSM,FIB-4 and eGFR in group A were(7.1±1.7)kPa,(2.0±0.4)and(101.3±7.9)mL/min/1.73 m^(2),and(7.2±1.5)kPa,(1.6±0.3)and(100.9±8.2)mL/min/1.73 m^(2),and they were(7.3±1.6)kPa,(2.2±0.5)and(95.6±8.0)mL/min/1.73 m^(2)(P<0.05),and(7.1±1.6)kPa,(1.6±0.4)and(94.0±7.6)mL/min/1.73 m^(2)(P<0.05),not but eGFR,significantly different compared to in group B.Conclusion The oral administration of tenofovir amibufenamide in the treatment of patients with CHB could obtain the same good antiviral efficacy,but might has less untoward impact on renal functions,and warrants further clinical investigation.
作者
高丽娟
李永库
董新颖
杨艺宁
冷雪君
Gao Lijuan;Li Yongku;Dong Xinying(Department of Infectious Diseases,Kowloon Hospital,Affiliated to Shanghai JiaoTong University,Suzhou 215028,Jiangsu Province,China)
出处
《实用肝脏病杂志》
CAS
2023年第6期789-792,共4页
Journal of Practical Hepatology
基金
苏州市卫生健康局科教兴卫青年科技基金资助项目(编号:KJXW2011017)。
