阿德福韦酯治疗老年慢性乙肝患者的安全性及疗效
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302医院临床创新课题(42413HOF)


Adefovir dipivoxii for treatment of elderly patients with chronic hepatitis B
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    摘要:

    目的探讨阿德福韦酯在65岁以上老年乙型肝炎患者中抗病毒的有效性和安全性。方法选取2006年10月至2009年10月就诊的30例65岁以上乙肝患者为老年组,60例65岁以下的乙肝患者为非老年组,均常规口服阿德福韦酯,10mg/d,分别观察治疗前,治疗4、8、12、24、36、48周时的肝功能、HBV DNA以及肾功能、血糖、血脂、血常规等指标。结果治疗48周时两组肝功能复常率分别为76%(13/17)和80%(28/35),HBV DNA阴转率分别为83%(25/30)和73%(44/60),肝功能复常时间为(78±73)d和(69±53)d,HBV DNA阴转时间为(124±75)d和(145±76)d,两组比较差异均无统计学意义(P>0.05)。两组患者在各时间点的平均肌酐水平的差异均无统计学意义,但治疗48周时,非老年组有2例肌酐高于正常值,1例更换治疗,两组患者均未见其他明显不良反应。结论老年乙肝患者应用阿德福韦酯抗病毒治疗同非老年人一样安全有效。

    Abstract:

    Objective To evaluate the efficacy and safety of adefovir dipivoxil for elderly patients (age≥65 years) with chronic hepatitis B.Methods Ninety patients with chronic hepatitis B were divided into two groups: the elderly group (30 cases,age ≥65 years) and the non-elderly group (60 cases,age <65 years).All subjects received oral administration of adefovir dipivoxil (10 mg/d).The laboratory data,such as the hepatic functions,serum HBV DNA levels,renal function,glucose,total cholesterol and blood routine indices,were compared between the two groups before and at 4,8,12,24,36,48 weeks after adefovir dipivoxil administration.Results At 48 weeks after adefovir dipivoxil administration,the normalization rates of hepatic function in elderly group and non-elderly group were 76% (13/17) and 80% (28/35),separately,and it took (78±73) and (69±53) days respectively for the patients in two groups to recover to normal hepatic fucntion(P>0.05).The sero-conversion rates of HBV DNA were 83%(25/30) and 73%(44/60 in two groups),respectively ,and it took (124±75) and (145±76) days respectively for serum HBV-DNA being suppressed within undetectable level in two groups(P>0.05).There was no difference in sera creatinine between the two groups at all time points.However,at 48 weeks,there were 2 cases who had serum creatinine higher than the normal upper limit in non-elderly group,and treatment changed for one case.No other adverse effect was observed in all patients.Conclusion Adefovir dipivoxil for treatment of chronic hepatitis B is safe and effective for non-elderly patients,as well as for the elderly patients.

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吉英杰,张文瑾,范振平,罗生强,蔡少平,高峰,张海燕.阿德福韦酯治疗老年慢性乙肝患者的安全性及疗效[J].中华老年多器官疾病杂志,2010,9(6):501~504

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