肝脏 ›› 2025, Vol. 30 ›› Issue (7): 953-957.

• 病毒性肝炎 • 上一篇    下一篇

艾米替诺福韦治疗慢性乙型肝炎的早期疗效及安全性

田小利, 陈炘, 倪艳, 吴松林, 邓存良   

  1. 646000 泸州 西南医科大学附属医院感染病科(田小利,倪艳,邓存良),重症医学科(吴松林);641000 内江 内江市第一人民医院感染病科(陈炘)
  • 收稿日期:2024-10-27 出版日期:2025-07-31 发布日期:2025-08-11
  • 通讯作者: 邓存良,Email:dengcunl@swmu.edu.com
  • 基金资助:
    四川省科技厅资助项目(18199)

Clinical research on early efficacy and safety of TMF for the treatment of patients with chronic hepatitis B

TIAN Xiao-li1, CHEN Xin2, NI Yan1, WU Song-lin3, DENG Cun-liang1   

  1. 1. Department of Infectious Diseases, the Affiliated Hospital of Southwest Medical University, Luzhou 646000, China;
    2. Department of Infectious Diseases, First People′s Hospital of Neijiang City, Neijiang 641000, China;
    3. Department of Critical Care Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, China
  • Received:2024-10-27 Online:2025-07-31 Published:2025-08-11
  • Contact: DENG Cun-liang,Email:dengcunl@swmu.edu.com

摘要: 目的 比较艾米替诺福韦(TMF)和富马酸丙酚替诺福韦(TAF)治疗慢性乙型肝炎(CHB)24周的疗效和安全性。方法 收集2022年8月至2023年7月西南医科大学附属医院及内江市第一人民医院就诊CHB患者的临床资料。TMF组纳入患者64例,其中初治34例,经治30例。TAF组纳入患者57例,其中初治25例,经治32例。比较两组患者基线临床资料、治疗24周时病毒学应答率、ALT复常率、HBsAg、肾功能和血脂的变化情况。结果 基线时,TMF组和TAF组的年龄、ALT、HBV DNA、HBsAg比较差异均无统计学意义(P>0.05)。治疗24周时,两组患者ΔHBsAg(TMF-477.98 IU/mL比TAF-133.63 IU/mL,P=0.117)差异无统计学意义,病毒学应答率(95.31%比84.21%,P=0.041)差异有统计学意义,但ALT复常率、△Cr、△eGFR、△TG、△TC差异无统计学意义(P>0.05)。初治患者TMF组24周病毒学应答率较TAF组高,为97.05%比76.00%,差异有统计学意义(P=0.013)。结论 TMF治疗CHB早期疗效确切,对肾脏功能、血脂代谢无显著影响。初治患者采用TMF治疗24周时比TAF具有更高的病毒学应答率。

关键词: 慢性乙型肝炎, 艾米替诺福韦, 富马酸丙酚替诺福韦

Abstract: Objective This study aimed to reveal the effectiveness and safety of tenofovir amibufenamide (TMF) in the real world,compared with tenofovir alafenamide (TAF) in patients with chronic hepatitis B (CHB). Methods In this study, TMF or TAF treated-chronic hepatitis B patients were included at the Affiliated Hospital of Southwest Medical University and the First People′s Hospital of Neijiang City from August 2022 to July 2023. 64 patients were included in the TMF group, 57 patients were included in the TAF group. All patients received 24 weeks of treatment.The virological response (HBV DNA < 100 IU/mL) rate, alanine aminotransferase recovery (ALT<40 U/L) rate,changes of hepatitis B surface antigen (HBsAg), renal function, and blood lipid profile were compared between baseline and after 24 weeks of treatment (intergroup and intragroup). Results At baseline, the age, ALT, HBVDNA, and HBsAg levels of the patients in the TMF group and the TAF group were not statistical significance between two groups (P>0. 05). After 24 weeks of treatment, △HBsAg, virological response (VR) rate in TMF group and TAF group were (TMF -477.98 IU/mL vs. TAF -133.63 IU/mL, P=0.117)、(95.31% vs. 84.21%, P=0.041),respectively. After 24 weeks of treatment, ALT recovery rate, △Cr, △eGFR, △TG, and △TC were not statistical significance between two groups (P>0. 05). For treatment-naive patients, VR rates at week 24 were 97.05% in the TMF group and 76% in the TAF group (P=0.013). Conclusion TMF had profound antiviral effectiveness and no adverse effects on renal function or blood lipids. Additionally, TMF was more efficient than TAF in inhibiting viral replication for treatment-naive patients.

Key words: Chronic hepatitis B, Tenofovir amibufenamide, Tenofovir alafenamide