肝脏 ›› 2016, Vol. 21 ›› Issue (5): 341-343.

• 论著 • 上一篇    下一篇

阿德福韦酯对慢性乙型肝炎患者血磷和骨密度的影响

刘玉柱, 闵祥玺   

  1. 273400 山东省费县人民医院感染科(刘玉柱),检验科(闵祥玺)
  • 收稿日期:2015-11-20 出版日期:2016-05-31 发布日期:2020-07-09

Effects of adefovir dipivoxil on serum phosphate level and bone mineral density in patients with chronic hepatitis B

LIU Yu-zhu, MIN Xiang-xi   

  1. Department of Infectious Diseases, Feixian County People’s Hospital, Shandong 273400, China
  • Received:2015-11-20 Online:2016-05-31 Published:2020-07-09

摘要: 目的 观察分析阿德福韦酯治疗慢性乙型肝炎患者时低血磷血症发生情况及对骨密度的影响。方法 选取口服阿德福韦酯治疗2年以上慢性乙型肝炎患者148例,测定患者血磷浓度,分析低血磷血症发生高危因素,探讨其骨密度异常相关影响。结果 阿德福韦酯治疗148例患者共发生低血磷血症42例(28.4%),骨密度异常35例(23.6),年龄>60岁、连续用药超过48个月是低血磷血症发生的高危因素。低血磷血症患者骨密度异常发生率高于非低血磷血症患者(χ2=60.101,P<0.05),随着低血磷血症程度的增高,骨密度异常发生率有显著增高,差异有统计学意义(P<0.05)。结论 长期服用阿德福韦酯可导致肾损伤,表现为低磷血症及低磷血性骨软化症、骨质疏松症等骨密度异常症状。

关键词: 阿德福韦酯, 慢性乙型病毒性肝炎, 低血磷血症, 骨密度

Abstract: Objective To investigate hypophosphatemia in chronic hepatitis B (CHB) patients with adefovir dipivoxil treatment, and its effect on bone mineral density.Methods One hundred and forty-eight CHB patients who had received adefovir dipivoxil treatment over 2 years were enrolled in the study. Fasting peripheral blood were collected for detection of phosphorus concentration, then high risk factors for hypophosphatemia and its effects on abnormal bone mineral density were analyzed.Results Among the 148 patients, hypophosphatemia occurred in 42 cases (28.4%) and abnormal bone mineral density was detected in 35 cases (23.6%). Age over 60 and continuous medication of adefovir dipivoxil for more than 48 months were high risk factors hypophosphatemia. The incidence of abnormal bone mineral density in patients with hypophosphatemia was higher than that in patients with normal serum phosphate levels (χ2=60.101, P<0.05). Level of serum phosphorus showed significantly negative correlation with incidence rate of abnormal bone mineral density (P<0.05).Conclusion Long-term medication of adefovir dipivoxil for CHB patients can lead to kidney damages with manifestation of hypophosphatemia, hypophophatemic oestemalacia, osteoporosis and other bone mineral density anomaly symptoms.

Key words: Adefovir dipivoxil; Chronic hepatitis B; Hypophosphatemia; Bone mineral density