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接受含索磷布韦方案治疗的丙型肝炎肝硬化患者肾功能指标的变化

Changes in renal function indices in cirrhotic chronic hepatitis C patients treated with sofosbuvir-containing regimens.

作者信息

Chen Jianhong, Zhang Xiaxia, Luo Hao, Wu Chihong, Yu Min, Liu Dan, Xi Hongli, Zhou Yihang, An Yaoyu, Xu Xiaoyuan

机构信息

Department of Infectious Disease, Peking University First Hospital, Beijing 100034, China.

出版信息

Oncotarget. 2017 Jun 28;8(53):90916-90924. doi: 10.18632/oncotarget.18701. eCollection 2017 Oct 31.

Abstract

This study aimed to explore changes in hepatic and renal function indices in chronic hepatitis C (CHC) patients treated with direct-acting antivirals (DAAs). Forty-three CHC patients treated with sofosbuvir (SOF)-containing regimens were enrolled. At the end of treatment, the estimated glomerular filtration rate (eGFR) level was significantly decreased and the serum creatinine (Scr) and uric acid (UA) levels were significantly increased compared with baseline levels (eGFR: 86.7 ± 20.4 vs 80.5 ± 21.3, = 0.005; Scr: 83.9 ± 19.1 vs 89.6 ± 21.1, < 0.001; UA: 323.7± 86.2 vs 358.5 ± 93.2, < 0.001); no significant improvements were observed at 24 w post-treatment (eGFR: 86.7 ± 20.4 vs 81.4 ± 18.6, = 0.013; Scr: 83.6 ± 17.9 vs 87.9 ± 18.3, = 0.014; UA: 320.8 ± 76.3 vs 349.3 ± 91.0, = 0.004). When the patients were grouped by liver conditions, non-cirrhotic patients and cirrhotic patients had decreased eGFR levels and increased Scr levels at the end of treatment; at 24 w post-treatment, the eGFR and Scr levels were significantly improved in non-cirrhotic patients (88.4 ± 21.7 vs 83.8 ± 18.5, = 0.142; 84.4 ± 20.4 vs 87.0 ± 16.9, = 0.088), while no obvious improvements were observed in cirrhotic patients (84.3 ± 18.7 vs 78.1 ± 18.6, = 0.002; 83.2 ± 17.7 vs 89.2 ± 20.6, = 0.006). Clinical physicians should closely monitor renal function in patients treated with SOF-containing regimens, especially in cirrhotic patients.

摘要

本研究旨在探讨接受直接抗病毒药物(DAAs)治疗的慢性丙型肝炎(CHC)患者肝肾功能指标的变化。纳入了43例接受含索磷布韦(SOF)方案治疗的CHC患者。治疗结束时,与基线水平相比,估计肾小球滤过率(eGFR)水平显著降低,血清肌酐(Scr)和尿酸(UA)水平显著升高(eGFR:86.7±20.4 vs 80.5±21.3,P = 0.005;Scr:83.9±19.1 vs 89.6±21.1,P<0.001;UA:323.7±86.2 vs 358.5±93.2,P<0.001);治疗后24周未观察到显著改善(eGFR:86.7±20.4 vs 81.4±18.6,P = 0.013;Scr:83.6±17.9 vs 87.9±18.3,P = 0.014;UA:320.8±76.3 vs 349.3±91.0,P = 0.004)。当根据肝脏情况对患者进行分组时,非肝硬化患者和肝硬化患者在治疗结束时eGFR水平降低,Scr水平升高;治疗后24周,非肝硬化患者的eGFR和Scr水平有显著改善(88.4±21.7 vs 83.8±18.5,P = 0.142;84.4±20.4 vs 87.0±16.9,P = 0.088),而肝硬化患者未观察到明显改善(84.3±18.7 vs 78.1±18.6,P = 0.002;83.2±17.7 vs 89.2±20.6,P = 0.006)。临床医生应密切监测接受含SOF方案治疗患者的肾功能,尤其是肝硬化患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bc93/5710894/bf6711b7483d/oncotarget-08-90916-g001.jpg

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