set of rare but serious side effects of nucleoside analog anti-viral drugs is called lactic acidosis and severe hepatomegaly with steatosis (an enlarged fatty liver).
相比之下, 核苷类药物在治疗乙肝, 肝硬化中是非常安全的, 但是如果医生盲目用药, 或患者用药治疗太晚, 或患者检查指标很差很差低于底线, 核苷类药物也会很罕见地造成一个暂时的副作用(side effects), 这个副作用叫"乳酸酸中毒 (Lactic Acidosis)"和"肝脏脂肪性肿大".
Women, especially those who are oveweight, are particularly at risk. This set of side effects is probably the result of mitochondrial toxicity. Mitochondria are cell's power organs that supply the energy needed for normal cell growth. Anti-viral nucleoside analogs impair the function of mitochondria. This can lead to increased acid levels in the blood, and an enlarged fatty liver. The symptoms are severe nausea, shortness of breath and vomiting that does not get better. If you are taking anti-viral drugs and experience these symptoms, tell your provider immediately.
女性, 特别是这些体重过重的比较容易犯病. 这组副作用可能是因为线粒体(mitochondrial)毒素造成. 线粒体是细胞的动力器官, 供给细胞能量, 让细胞正常运作. 抗病毒核苷类药物瘫痪了线粒体的运作. 这会造成血液循环系统中酸性增加, 脂肪性肝肿大. 症状是恶心, 呼吸短促和不能控制的呕吐. 如果你在服用核苷类药物发生这样的情况, 应该和你的医生接洽.
If you're going to use Epivir, it's important to check for infection with hepatitis B(such liver funtion, viral load, biopsy, especially those who are having decompenated liver diseases).
如果你要用拉米, 检查肝脏功能, 血液, 病毒, 病理是非常重要的. 特别是那些非代偿期的患者. (为什么一再强调需要治疗合并症为首要, 在不出血, 没有腹水感染或没有肝脏功能很差很差的情况下--不低于底线或有其它问题, 或在滥用其它药物, 再考虑用药)
If you have active hepatitis B when you start Epivir, you may feel sick for a month or two because liver cells infected with hepatitis B die off. Liver enzymes may also increase temporarily. These symptoms are a lot like some drug side effects, and knowing your hepatitis status can help tell the difference. There have also been several reports of hepatitis B flare-ups when Epivir treatment is stopped. Symptoms of hepatitis B flare-ups are high liver enzymes, yellow skin (jaundice), nausea, vomiting, fatigue, abdominal and joint pain.
在你服用拉米的头1也许2个月的时间内, 你可能(可能不是每个人, 因为这个情况是罕见的-rare的)会感觉生病的样子. 因为被感染HBV的肝细胞在死亡. 你的ALT也可能会暂时升高(暂时的), 这些感觉好比药物副作用, 知道这个你就不会担心, 给与区别. 另外, 拉米不能盲目停止使用因为HBV可能会(可能)回升. HBV回升的症状是ALT升高, 黄疸, 恶心, 呕吐, 疲劳, 腹部和关节疼痛等.
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也就是说(简单说), 拉米起药后因为极少数一部分人有短时间线粒体被瘫痪. 瘫痪的原因是因为拉米是利用假的DNA混乱病毒, 将假的DNA弄进入病毒, 在逆反录DNA程序上瘫痪了病毒复制, 也就让病毒得到抑制. 但是在这个假DNA以假乱真的过程中, 假的DNA也会在一小部分人身上也糊弄了线粒体的DNA造成其瘫痪. 当细胞的能量供给器官线粒体被瘫痪后, 细胞死亡造成ALT升高, 或乳酸酸中毒. 有的时候这个过程仅仅是暂时的, 有的时候会是长期的. 所以用药需要评估, 随访, 跟踪, 定期检查. 发现问题更正. 患者应该尽量早确诊明了自己的肝脏状况, 特别是其病理状态, 尽量早治疗抑制病毒介导的肝损害. 等到最后不行了, 要用药没有空间有这些变故.
发表于 2006-1-16 01:30
