本文選題：慢性乙型病毒性肝炎患者　切入點(diǎn)：核苷酸類抗病毒藥物　出處：《蚌埠醫(yī)學(xué)院》2017年碩士論文

【摘要】：目的:了解既往已服用核苷酸類抗病毒藥物慢乙肝患者腎功能異常情況并對其腎功能異常危險因素進(jìn)行分析。方法:收集2013-11~2015-10月我院住院治療及2015-9~2015-12在門診就診的慢性乙型病毒性肝炎患者,將其分為阿德福韋酯組(ADV組)、阿德福韋酯聯(lián)合拉米夫定組(ADV/LAM組)、恩替卡韋組(ETV組)、拉米夫定組(LAM組)四組,應(yīng)用簡化腎臟病飲食調(diào)整工作組(MDRD)方程估算患者的e-GFR值,計算該人群中腎功能異常率(e-GFR90 ml/min/1.73m2),同時對其高危因素行單因素和多因素二分類Logistic回歸分析。結(jié)果:1.本研究共收集216例病例,樣本總體腎功能異常率為19.9%(43/216),其中ADV組、ADV/LAM組、ETV組、LAM組腎功能異常率分別31%,33.3%,13.2%,13.8%,總體差異有統(tǒng)計學(xué)意義(X2=10.613,P=0.014),然而組間兩兩比較,差異無統(tǒng)計學(xué)意義(P0.008)。ADV組和ADV/LAM組治療組患者腎功能異常率明顯高于LAM組和ETV組,差異有統(tǒng)計學(xué)意義(P0.001)。2.二分類Logistic回歸分析結(jié)果提示,阿德福韋酯(OR=6.370,P=0.002),阿德福韋酯聯(lián)合拉米夫定(OR=4.945,P=0.008),年齡(OR=1.060,P=0.004),糖尿病(OR=4.221,P=0.012)是其腎功能異常的顯著危險因素.結(jié)論:長期服用核苷酸類抗病毒治療的慢性乙型病毒性肝炎患者,尤其是服用阿德福韋酯單藥或聯(lián)合拉米夫定治療的老年患者,應(yīng)密切監(jiān)測其腎功能,以便發(fā)現(xiàn)早期腎功能不全。
[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爺絀跺叡鏀墮泦216渚嬬梾渚，

本文編號：1710670