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核苷酸类抗病毒药物经治慢乙肝患者肾功调查及其危险因素分析

发布时间:2018-04-04 16:04

  本文选题:慢性乙型病毒性肝炎患者 切入点:核苷酸类抗病毒药物 出处:《蚌埠医学院》2017年硕士论文


【摘要】:目的:了解既往已服用核苷酸类抗病毒药物慢乙肝患者肾功能异常情况并对其肾功能异常危险因素进行分析。方法:收集2013-11~2015-10月我院住院治疗及2015-9~2015-12在门诊就诊的慢性乙型病毒性肝炎患者,将其分为阿德福韦酯组(ADV组)、阿德福韦酯联合拉米夫定组(ADV/LAM组)、恩替卡韦组(ETV组)、拉米夫定组(LAM组)四组,应用简化肾脏病饮食调整工作组(MDRD)方程估算患者的e-GFR值,计算该人群中肾功能异常率(e-GFR90 ml/min/1.73m2),同时对其高危因素行单因素和多因素二分类Logistic回归分析。结果:1.本研究共收集216例病例,样本总体肾功能异常率为19.9%(43/216),其中ADV组、ADV/LAM组、ETV组、LAM组肾功能异常率分别31%,33.3%,13.2%,13.8%,总体差异有统计学意义(X2=10.613,P=0.014),然而组间两两比较,差异无统计学意义(P0.008)。ADV组和ADV/LAM组治疗组患者肾功能异常率明显高于LAM组和ETV组,差异有统计学意义(P0.001)。2.二分类Logistic回归分析结果提示,阿德福韦酯(OR=6.370,P=0.002),阿德福韦酯联合拉米夫定(OR=4.945,P=0.008),年龄(OR=1.060,P=0.004),糖尿病(OR=4.221,P=0.012)是其肾功能异常的显著危险因素.结论:长期服用核苷酸类抗病毒治疗的慢性乙型病毒性肝炎患者,尤其是服用阿德福韦酯单药或联合拉米夫定治疗的老年患者,应密切监测其肾功能,以便发现早期肾功能不全。
[Abstract]:Objective: to investigate the abnormal renal function in patients with chronic hepatitis B (CHB) who have taken nucleotide antiviral drugs and analyze the risk factors of abnormal renal function.Methods: patients with chronic viral hepatitis B (CHH) who were hospitalized in our hospital from 2013-11 to 2015-October and treated in outpatient clinic in 2015-92015-12 were collected.The patients were divided into four groups: adefovir group, adefovir combined with lamivudine group, ETV group and lamivudine group). The e-GFR value of patients was estimated by the simplified kidney disease diet adjustment working group (SDD) equation.The rate of abnormal renal function in this population was calculated and the risk factors were analyzed by univariate and multivariate Logistic regression analysis.The result is 1: 1.鏈爺绌跺叡鏀堕泦216渚嬬梾渚,

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