替比夫定抗病毒治疗乙型肝炎病毒相关性肾小球肾炎患者的

StephenW

Medicine (Baltimore). 2018 Aug;97(31):e11716. doi: 10.1097/MD.0000000000011716.
Effectiveness of telbivudine antiviral treatment in patients with hepatitis B virus-associated glomerulonephritis: A 104-week pilot study.
Yan Z1, Qiao B2, Zhang H2, Wang Y3, Gou W2.
Author information

1
    Lab of Glycobiololgy, School of Medicine and Pharmacy, Ocean University of China.
2
    The sixth Department of Hepatology.
3
    Department of Dermatology, No. 6 People's Hospital of Qingdao, Qingdao, Shandong, China.

Abstract

The aim of this study was to evaluate clinical efficacy of telbivudine in treatment of hepatitis B virus-associated glomerulonephritis (HBV-GN).A total of 43 HBV-GN patients combined with chronic hepatitis B were treated with telbivudine for 104 weeks. Serum levels of HBV DNA viral load, HBeAg, HBeAb, alanine aminotransferase (ALT), aspartate aminotransferase (AST), serum creatinine (Cr), and 24-hour urinary protein were evaluated after telbivudine treatment of 12, 24, 52, 76, and 104 weeks. Estimated glomerular filtration rate (eGFR) was calculated at baseline, 24 weeks, 52 weeks, and 104 weeks of treatment, respectively. Complete remission (CR) was defined as urinary protein <0.3 g/day, with normal ALT, AST, Cr, and eGFR. Criteria for partial remission include: 24-hour urinary protein excretion decreased by >50% compared with baseline level, and ALT and AST decreased >50%.Proteinuria level gradually decreased in patients with HBV-GN after telbivudine treatment. The percentages of PR + CR were 90.7% and 95.3%, respectively, at 52 and 104 weeks. Compared to baseline, eGFR were significantly increased from 69.2 ± 23.1 mL/min/1.73 m to 116.2 ± 26.3 mL/min/1.73 m at 104 weeks of treatment. Multivariate analysis indicated that baseline HBV DNA viral load (odds ratio [OR] = 1.19, 95% confidence interval [CI] 1.11-2.19, P = .02) and baseline urinary protein (OR = 1.08, 95% CI 1.04-2.44, P = .03) were independent risk factors associated with CR after telbivudine treatment among patients with HBV-GN.Our study demonstrates that telbivudine can be used to treat HBV-GN and effectively improve eGFR in these patients.

PMID:
    30075577
DOI:
    10.1097/MD.0000000000011716

StephenW

医学（巴尔的摩）。 2018年8月; 97（31）：e11716。 doi：10.1097 / MD.0000000000011716。
替比夫定抗病毒治疗乙型肝炎病毒相关性肾小球肾炎患者的有效性：为期104周的试验研究。
严Z1，乔B2，张H2，王Y3，苟W2。
作者信息

1
    中国海洋大学医学与药学院糖生物学实验室。
2
    第六届肝病科。
3
    青岛市第六人民医院皮肤科，山东青岛

抽象

本研究的目的是评估替比夫定治疗乙型肝炎病毒相关性肾小球肾炎（HBV-GN）的临床疗效。共有43名HBV-GN患者合并慢性乙型肝炎患者接受替比夫定治疗104周。 telbivudine治疗12,24,52,76后，评估血清HBV DNA病毒载量，HBeAg，HBeAb，丙氨酸氨基转移酶（ALT），天冬氨酸氨基转移酶（AST），血清肌酐（Cr）和24小时尿蛋白的水平，和104周。在基线，24周，52周和104周分别计算估计的肾小球滤过率（eGFR）。完全缓解（CR）定义为尿蛋白<0.3g /天，具有正常的ALT，AST，Cr和eGFR。部分缓解的标准包括：24小时尿蛋白排泄量与基线水平相比下降> 50％，ALT和AST下降> 50％。替比夫定治疗后HBV-GN患者的蛋白尿水平逐渐下降。在第52周和第104周，PR + CR的百分比分别为90.7％和95.3％。与基线相比，治疗104周时eGFR从69.2±23.1 mL / min / 1.73 m显着增加至116.2±26.3 mL / min / 1.73 m。多变量分析表明基线HBV DNA病毒载量（优势比[OR] = 1.19,95％置信区间[CI] 1.11-2.19，P = .02）和基线尿蛋白（OR = 1.08,95％CI 1.04-2.44， P = .03）是HBV-GN患者接受替比夫定治疗后与CR相关的独立危险因素。我们的研究表明替比夫定可用于治疗HBV-GN并有效改善这些患者的eGFR。

结论：
    30075577
DOI：
    10.1097 / MD.0000000000011716