| 刘德才,郑世维,胡学伏.阿德福韦酯致范可尼综合征及多处骨折1例[J].浙江中西医结合杂志,2025,35(2): |
| 阿德福韦酯致范可尼综合征及多处骨折1例 |
|
| 投稿时间：2024-05-26 修订日期：2024-09-25 |
| DOI： |
| 中文关键词: 阿德福韦酯 范可尼综合征 骨软化症 病例报告 |
| 英文关键词:Adefovir dipivoxil Fanconi syndrome Osteomalacia Case report |
| 基金项目:宜昌市中医医院院级科研 |
|
| 摘要点击次数: 314 |
| 全文下载次数: 2 |
| 中文摘要: |
| 阿德福韦酯是一种逆转移酶抑制剂，其能调节免疫和抑制肌纤维化进程，因此被视为治疗慢性乙型病毒性肝炎的一线用药[1]，阿德福韦酯主要通过肾脏来分解为原形，并排泄出去[2]。临床研究发现，阿德福韦酯对肾功能的影响与用药量呈正相关，使用阿德福韦酯30mg/日治疗5年，发现其肾功能损害的发生率为22%～50%，使用阿德福韦酯10mg/日进行治疗5年，患者肾功能受损的发生率在3%～8%[3]。长时间使用阿德福韦酯会损害肾小管上皮细胞，降低了肾小管对磷元素的吸收能力，引发低血磷性骨软化症，甚至出现继发性范可尼综合征[4]。现将我院2022年4月收治的一例因长期服用阿德福韦酯导致范可尼综合征及全身多处骨折病例报告如下。 |
| 英文摘要: |
| Objective To report the clinical case of a patient with Fanconi syndrome and multiple fractures caused by long-term use of low-dose adefovir diaxidate, so as to improve the knowledge of clinicians. Methods A retrospective case study was used to analyze the clinical data of a patient with Fanconi syndrome and multiple fractures caused by long-term oral administration of adefovir dipivoxil (10 mg/d) admitted to Yichang Hospital of Traditional Chinese Medicine in April 2022. Results The patient was a 62-year-old male who was diagnosed with "low back pain with pain in both hips and lower limbs for 4 months". The patient complained of a history of chronic hepatitis B and had been receiving oral adefovir diaxidate (10 mg/d) for antiviral treatment for 8 years. After admission, a thorough examination was conducted, and electrolyte indicated hypophosphatemia (0.62mmol /L). Blood alkaline phosphatase was elevated (212.3 IU/L), urine protein and urine sugar were positive, and imaging examination indicated multiple fractures throughout the body. When adefovir diaxidate was stopped and calcium supplement was given, the patient"s indicators gradually returned to normal level, while the patient"s bone pain was reduced, and walking basically returned to normal. Conclusion Long-term oral low-dose adefovir dipivoxil may lead to Fanconi syndrome and osteomalacia, and even multiple fractures. In order to prevent the occurrence of such a situation, three routine, electrolyte and bone mineral density should be monitored regularly when taking adefovir dipivoxil for hepatitis B. In case of adefovir dipivoxil related kidney injury, Adefovir diaxidate should be stopped immediately and by correcting electrolyte disturbances to avoid Fanconi syndrome. |
| 查看全文 查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
