乙型肝炎肝硬化合并肾损伤及抗病毒药物的应用

张洁冰; 郭宏华

doi:10.3969/j.issn.1001-5256.2019.01.042

乙型肝炎肝硬化合并肾损伤及抗病毒药物的应用

DOI: 10.3969/j.issn.1001-5256.2019.01.042

吉林大学中日联谊医院消化内科

详细信息

中图分类号: R512.62;R575.2;R692
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出版历程
- 出版日期: 2019-01-20

Research advances in hepatitis B cirrhosis with renal injury and the application of antiviral drugs

Department of Gastroenterology, China-Japan Union Hospital of Jilin University, Changchun 130033, China

摘要

摘要:
乙型肝炎肝硬化是HBV感染引起的慢性进展性疾病,易合并多种并发症(如上消化道出血、肝性脑病、肝肾综合征等),严重者进展为肝癌甚至死亡。另外HBV感染还是肾损伤的高危因素,其肾损伤发病率高于非HBV感染者,伴发肾损伤对乙型肝炎肝硬化患者危害严重,甚至合并肾衰竭,其预后差,病死率高。近年来,乙型肝炎肝硬化合并肾损伤成为研究热点,简述了乙型肝炎肝硬化合并肾损伤的检测指标研究进展,并比较了不同核苷酸类药物抗病毒治疗过程中对肾功能的影响,总结了肾损伤患者如何调整抗病毒用药的方案,提示早期识别并合理评估患者肾功能情况选择抗病毒药物有着非常重要的临床意义。
- 肝炎,乙型 /
- 肝硬化 /
- 肾功能不全 /
- 抗病毒药 /
- 综述
Abstract:
Hepatitis B cirrhosis is a chronic progressive disease caused by hepatitis B virus (HBV) infection and has various complications such as upper gastrointestinal bleeding, hepatic encephalopathy, and hepatorenal syndrome, and it may progress to liver cancer and even cause death in severe cases.In addition, HBV infection is also a high risk factor for renal injury, and patients with HBV infection had a higher incidence rate of renal injury than those without HBV infection.Renal injury does great harm to patients with hepatitis B cirrhosis, and some patients even have renal failure, with poor prognosis and high mortality.In recent years, hepatitis B cirrhosis with renal injury has become a research hotspot.This article briefly describes the research advances in the indices for hepatitis B cirrhosis with renal injury, compares the influence of different nucleotide analogues on renal function during antiviral therapy, and summarizes how to adjust the medication for patients with renal injury.It is pointed out that early identification and reasonable evaluation of renal function in patients has important clinical significance.
- hepatitis B /
- liver cirrhosis /
- renal insufficiency /
- antiviral agents /
- review

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