联合治疗拉米夫定和血管紧张素转换酶抑制剂/血管紧张素受

StephenW

Int Urol Nephrol. 2017 Mar 10. doi: 10.1007/s11255-017-1563-5. [Epub ahead of print]
Combination therapy with lamivudine and angiotensin-converting enzyme inhibitor/angiotensin receptor blocker for hepatitis B virus-associated glomerulonephritis with mild to moderate proteinuria: a clinical review of 38 cases.Sun LJ1,2, Shan JP3, Cui RL4, Yuan WJ4, Jiang GR3.
Author information
1Department of Nephrology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, 200092, China. [email protected].2Department of Nephrology, Changhai Hospital Affiliated to the Second Military Medical University, Shanghai, 200433, China. [email protected].3Department of Nephrology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, 200092, China.4Department of Nephrology, Changhai Hospital Affiliated to the Second Military Medical University, Shanghai, 200433, China.

AbstractPURPOSE: The treatment of HBV-associated glomerulonephritis (HBV-GN) is still a challenge in clinical practice now. The objective of this study was to report the pathological characteristics of HBV-GN presenting with mild to moderate proteinuria and to evaluate the therapeutic efficacy of lamivudine (LAM) in combination with angiotensin-converting enzyme inhibitor (ACEI)/angiotensin receptor blocker (ARB) as compared to ACEI/ARB monotherapy.
METHODS: We conducted a retrospective observational study in HBV-GN patients between 2005 and 2014. The patients were classified into two groups: Group 1 included patients treated with LAM plus ACEI/ARB (n = 20), and group 2, patients treated with ACEI/ARB alone (n = 18). Their clinical and pathological characteristics were collected; we analyzed the therapeutic responses and assessed the correlation between renal and liver pathologies.
RESULTS: Our results showed that the most common type of HBV-GN was IgA nephropathy. LAM plus ACEI/ARB therapy was better in reducing 24-h urinary protein excretion, alanine aminotransferase, and aspartate aminotransferase levels, while maintaining the level of kidney function. The proportion of patients who achieved remission (CR + PR) was higher in the LAM plus ACEI/ARB group than in the ACEI/ARB monotherapy group (χ 2 = 5.371, P = 0.035).
CONCLUSION: In the HBV-GN patients with mild to moderate proteinuria, LAM plus ACEI/ARB not only improved liver function but also better reduced 24-h proteinuria.


KEYWORDS: ACEI; ARB; HBV-associated glomerulonephritis; Lamivudine; Therapeutic efficacy

PMID:28283858DOI:10.1007/s11255-017-1563-5

StephenW

Int Urol Nephrol。 2017年3月10日。doi：10.1007 / s11255-017-1563-5。 [打印前的电子版]
联合治疗拉米夫定和血管紧张素转换酶抑制剂/血管紧张素受体阻断剂乙型肝炎病毒相关性肾小球肾炎伴轻度至中度蛋白尿：临床综述38例。
孙LJ1,2，山JP3，Cui RL4，Yuan WJ4，Jiang GR3。
作者信息

1
    上海交通大学医学院附属新华医院肾脏科上海200092。 [email protected]。
2
    第二军医大学附属长海医院肾脏科上海，200433。 [email protected]。
3
    上海交通大学医学院附属新华医院肾脏科上海200092。
4
    第二军医大学附属长海医院肾脏科上海，200433。

抽象
目的：

治疗HBV相关性肾小球肾炎（HBV-GN）在临床实践中仍然是一个挑战。本研究的目的是报告HBV-GN呈现轻度至中度蛋白尿的病理特征，并评估拉米夫定（LAM）联合血管紧张素转换酶抑制剂（ACEI）/血管紧张素受体阻断剂（ARB）的疗效，与ACEI / ARB单一疗法相比。
方法：

我们在2005年至2014年期间对HBV-GN患者进行了回顾性观察性研究。患者分为两组：第1组包括用LAM加ACEI / ARB治疗的患者（n = 20），第2组患者用ACEI / ARB单独（n = 18）。收集其临床和病理特征;我们分析了治疗反应，并评估肾脏和肝脏病理之间的相关性。
结果：

我们的研究结果表明，最常见的HBV-GN是IgA肾病。 LAM加ACEI / ARB治疗在减少24小时尿蛋白排泄，丙氨酸氨基转移酶和天冬氨酸氨基转移酶水平，同时保持肾功能水平更好。实施缓解的患者比例（CR + PR）在LAM加ACEI / ARB组比在ACEI / ARB单一治疗组高（χ2 = 5.371，P = 0.035）。
结论：

在轻度至中度蛋白尿的HBV-GN患者中，LAM加ACEI / ARB不仅改善了肝功能，而且更好地减少了24小时蛋白尿。
关键词：

ACEI; ARB; HBV相关性肾小球肾炎;拉米夫定;治疗功效

PMID：
    28283858
DOI：
    10.1007 / s11255-017-1563-5