临床肝胆病杂志2024，Vol.40Issue(10)：2008-2013,6.DOI:10.12449/JCH241013
富马酸丙酚替诺福韦治疗首次失代偿期乙型肝炎肝硬化患者的效果和安全性分析
Efficacy and safety of tenofovir alafenamide fumarate in patients with first-time hepatitis B virus-related decompensated cirrhosis
摘要
Abstract
Objective To investigate the application value of tenofovir alafenamide fumarate(TAF)in patients with first-time hepatitis B virus-related decompensated cirrhosis(HBV-DC)and its impact on renal function and lipid metabolism.Methods A total of 57 patients with first-time HBV-DC who were hospitalized and received TAF antiviral therapy in The Affiliated Hospital of Xuzhou Medical University from January 1,2020 to December 31,2022 were enrolled,and all of them received TAF antiviral therapy.Related data were collected at baseline and at weeks 12,24,and 48 of treatment,including virological and serological indicators,liver and renal function,serum phosphorus,and blood lipids.The paired t-test or single group repeated measures ANOVA were used for comparison of normally distributed continuous data,the Friedman test was used for comparison of non-normally distributed continuous data,and the chi-square test or the Fisher's exact test were used for categorical data.Results A total of 52 patients completed the 48 weeks of follow-up.After 12,24,and 48 weeks of treatment,the patients achieving HBV DNA seroconversion accounted for 38.5%,63.5%,and 84.6%,respectively;the alanine aminotransferase normalization rate were 71.2%,82.7%,and 82.7%,respectively;the proportion of the patients with Child-Pugh class A disease increased to 55.8%,73.1%,and 92.3%,respectively.Within the 48 weeks of treatment,there were significant increases in the levels of cystatin C(χ2=35.163,P＜0.001)and serum phosphorus(F=8.600,P＜0.001)and low-density lipoprotein cholesterol(χ2=10.064,P=0.018).The ratio of total cholesterol/high-density lipoprotein cholesterol decreased continuously from 3.61(2.61～5.84)to 3.27(2.70～4.36)(χ2=5.000,P=0.172).Conclusion TAF can rapidly inhibit HBV replication and significantly improve liver function in HBV-DC patients,with no significant impact on renal function.However,blood lipid should be closely monitored.关键词
乙型肝炎/肝硬化/富马酸丙酚替诺福韦/治疗结果Key words
Hepatitis B/Liver Cirrhosis/Tenofovir Alafenamide Fumarate/Treatment Outcome引用本文复制引用
荣欣欣,徐缘媛,杨广德,王霞,傅涓涓,李丽,潘修成..富马酸丙酚替诺福韦治疗首次失代偿期乙型肝炎肝硬化患者的效果和安全性分析[J].临床肝胆病杂志,2024,40(10):2008-2013,6.基金项目
国家科技重大专项(2018ZX10302206-001-003) National Science and Technology Major Projects(2018ZX10302206-001-003) （2018ZX10302206-001-003）
