第三代核苷（酸）类似物治疗肝硬化患者的骨密度评估：替

StephenW

Eur J Gastroenterol Hepatol. 2018 Jan 5. doi: 10.1097/MEG.0000000000001051. [Epub ahead of print]
Assessment of bone mineral density in patients with cirrhosis treated with third-generation nucleos(t)ide analogues: comparison between tenofovir and entecavir.Tonon M1, Piano S1, Romano A1, Fasolato S1, Stanco M1, Pilutti C1, Pontisso P1, Mareso S1, Gambino C1, Sartori L2, Angeli P1.
Author information
1Unit of Internal Medicine 5 and Hepatology (UIMH), Department of Medicine (DIMED).2Unit of Internal Medicine 1, Department of Medicine (DIMED), University of Padova, Padova, Italy.

AbstractBACKGROUND AND AIM: Tenofovir and entecavir are nowadays the first-line treatment in hepatitis B virus (HBV)-related cirrhosis. Both drugs were shown to be effective in HBV suppression and well tolerated. The effects of tenofovir on bone mineral density (BMD), however, were shown to worsen the rate of osteoporosis, which is already a common feature in cirrhosis. In contrast, entecavir seems to have no effect on mineral metabolism. The aim of our study was to compare the effects of nucleos(t)ide analogs on bone density in HBV-related cirrhosis.
PATIENTS AND METHODS: Fourty-eight patients were treated with tenofovir and 22 patients were treated with tenofovir, and were followed prospectively from 2008 to 2013. To evaluate BMD, laboratory examinations, dual-X-ray absorptiometry, and Fracture Risk Assessment Tool were assessed.
RESULTS: During the study, no difference was found between the two groups in the plasmatic concentration of calcium, phosphate, vitamin D, parathyroid hormone, or creatinine. Dual-X-ray absorptiometry showed no difference in the T-score and Fracture Risk Assessment Tool showed no significant difference in the 10-year risk of osteoporotic fractures in the two groups. On univariate and multivariate analyses, the only predictors of osteoporosis development were the prognostic scores of liver disease and BMI.
CONCLUSION: Both tenofovir and entecavir are effective in treating HBV in cirrhotic patients. The known effects of tenofovir on BMD do not worsen osteoporotic fractures risk compared with entecavir in these patients.

StephenW

Eur J Gastroenterol Hepatol。 2018年1月5日。doi：10.1097 / MEG.0000000000001051。 [电子版提前打印]
第三代核苷（酸）类似物治疗肝硬化患者的骨密度评估：替诺福韦和恩替卡韦之间的比较。
Tonon M1，Piano S1，Romano A1，Fasolato S1，Stanco M1，Pilutti C1，Pontisso P1，Mareso S1，Gambino C1，Sartori L2，Angeli P1。
作者信息

1
    内科和肝病学（UIMH）医学系（DIMED）。
2
    意大利帕多瓦大学医学系（DIMED）内科学单位1。

抽象
背景和目的：

替诺福韦和恩替卡韦是目前乙肝病毒（HBV）相关性肝硬化的一线治疗药物。两种药物均显示出对HBV抑制有效且耐受性良好。然而，替诺福韦对骨密度（BMD）的影响已经显示出使骨质疏松的速度恶化，这已经是肝硬化的共同特征。相反，恩替卡韦似乎对矿物质代谢没有影响。我们研究的目的是比较核苷（酸）类似物对HBV相关性肝硬化骨密度的影响。
患者和方法：

替诺福韦治疗48例，替诺福韦治疗22例，并在2008 - 2013年进行前瞻性随访。评估骨密度，实验室检查，双X线骨密度仪和骨折风险评估工具。
结果：

在研究期间，两组在钙，磷，维生素D，甲状旁腺激素或肌酸酐血浆浓度方面没有差异。双X射线吸收测量显示T评分无差异，骨折风险评估工具显示两组骨质疏松性骨折的10年风险无显着差异。在单变量和多变量分析中，骨质疏松症发生的唯一预测因素是肝病和BMI的预后评分。
结论：

替诺福韦和恩替卡韦均可有效治疗肝硬化患者的HBV。与恩替卡韦相比，替诺福韦对骨密度的已知​​影响不会使骨质疏松性骨折风险恶化。

9病成医

这可以算作好消息。

neilhbver

很好

小牡丹

逆转纤维化，核心是病毒不复制，国产恩替哪家能做到？歪嘴和尚念不出正经。很担心TAF国产后一样起不到应有的作用，病人还无法选择。这是个缺德药贩子的世界，不是亿人的。

newchinabok

回复 小牡丹 的帖子

国产仿制药不行就吃两片，还不行，就当吃蚕豆，磕瓜子。我感冒了，喝板兰根，一次喝四包，当糖水喝嘛

antiHBVren

回复 newchinabok 的帖子

为啥不换用质量高的药品呢；

是药三分毒

newchinabok

回复 antiHBVren 的帖子

开玩笑的话，黑色幽默。看来你没有幽默感

antiHBVren

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