¼ò
¤™
- ¼ò
- ·±
- EN
-
¹ØÓÚvic3308 ¤™
-
¿Æ¼¼Á¢Òì ¤™
-
²úÆ·ÓëÓªÒµ ¤™
-
ÐÂÎÅÖÐÐÄ ¤™
-
Ͷ×ÊÕß¹Øϵ ¤™
-
ESG ¤™
-
Ö°ÒµÉú³¤ ¤™
¼ò
¤™
- ÂýÐÔÒÒÐ͸ÎÑ×£¨CHB£©µÄÖÎÁÆÊÇÒ»³¡³¤ÆÚÕ½ £¬£¬£¬ £¬£¬»¼ÕßÐèÒª¸ßЧ¡¢Çå¾²µÄÒ©ÎïÀ´ºã¾Ã¿ØÖƲ¡¶¾¡¢ÑÓ»º¼²²¡Ï£Íû¡£¡£¡£¡£¡£
- Ä¿½ñÍƽø¡¶Öйú·ÀÖβ¡¶¾ÐÔ¸ÎÑ×Ðж¯ÍýÏ루2025¡ª2030Ä꣩¡·Àú³ÌÖÐ £¬£¬£¬ £¬£¬¹æ·¶»¯µÄ¿¹²¡¶¾ÖÎÁÆ £¬£¬£¬ £¬£¬ÊÇ´Ó¡°ÓÐÓÿØÖÆ¡±Ïò¡°¹¦Ð§ÐÔÖÎÓú¡±Âõ½øµÄ¿Æѧ»ù´¡Óë½¹µã»·½Ú¡£¡£¡£¡£¡£
- ´Ó48ÖÜ¡¢96ÖÜ¡¢144ÖÜÖ±ÖÁ240ÖÜ£¨5Ä꣩ £¬£¬£¬ £¬£¬ºããå?µÄ¿¹²¡¶¾ÁÆЧ¼°Çå¾²ÐÔÀú¾Á˲î±ð½×¶ÎÁÙ´²Ñо¿µÄºã¾ÃÑÏ¿áÑéÖ¤¡£¡£¡£¡£¡£
¸øÒ©4Öܲ¡¶¾ÔØÁ¿ÏÔ×ÅϽµ£º¢óÆÚ48ÖÜÑо¿Êý¾ÝÏÔʾ £¬£¬£¬ £¬£¬ÎÞÂÛÊÇHBeAgÑôÐÔÕÕ¾ÉHBeAgÒõÐÔ»¼Õß £¬£¬£¬ £¬£¬TMF×éÔÚ¸øÒ©µÚ4ÖÜʱ²¡¶¾ÔØÁ¿¾ùÏÔ×ÅϽµ £¬£¬£¬ £¬£¬Ï½µ·ù¶È»®·ÖΪ2.84ºÍ2.81 log10 IU/ml[5]¡£¡£¡£¡£¡£
5Ä겡¶¾Ñ§ÒÖÖÆÂʸߴï95%£º¢óÆÚÍ·¶ÔÍ·Ñо¿ÖÐ £¬£¬£¬ £¬£¬ºããå?ÖÎÁÆ48ÖܺÍ96ÖÜÔÚ²¡¶¾Ñ§Ó¦´ð£¨HBV DNA <20 IU/mL£©ÉϾù·ÇÁÓЧÓÚTDF±ÈÕÕ×é[5,6]¡£¡£¡£¡£¡£ÇÒÁÆЧËæʱ¼äÒ»Á¬ÌáÉý£ºÖÎÁÆ144ÖÜʱ £¬£¬£¬ £¬£¬Î¬³ÖTMFÖÎÁÆ×黼ÕßHBV DNA <20 IU/mL±ÈÀý´ï86.2%[7]£»£»£»£»£»£»¶ø240ÖÜ£¨Ô¼5Ä꣩ʱ £¬£¬£¬ £¬£¬ÕâÒ»±ÈÀý½øÒ»²½ÌáÉýÖÁ95% £¬£¬£¬ £¬£¬ÆäÖиߴï92%µÄ»¼ÕßʵÏÖÁËHBV DNA<10 IU/mLµÄ¸ü¸ßÖÎÁƱê×¼[8]¡£¡£¡£¡£¡£Òâζ×ÅTMFºã¾ÃÖÎÁÆÄÜʹ¾ø´ó´ó¶¼»¼ÕßʵÏÖ²¡¶¾Ñ§ÒÖÖÆ¡£¡£¡£¡£¡£
¸ß²¡¶¾ÔØÁ¿ÈËȺҲÏÔ×Å»ñÒ棺×ÝÈ»ÔÚ»ùÏ߸߲¡¶¾ÔØÁ¿ÕâÒ»ÄÑÖÎÈËȺÖÐ £¬£¬£¬ £¬£¬ºããå?ͬÑùÕ¹ÏÖ³öǿЧµÄ²¡¶¾Ñ§ÒÖÖÆÄÜÁ¦¡£¡£¡£¡£¡£ÔÚÍê³É144ÖÜÖÎÁÆʱ £¬£¬£¬ £¬£¬Î¬³ÖTMFÖÎÁÆ×éÓëTDFתTMFÖÎÁÆ×éÖлùÏßHBV DNA¡Ý8 log10 IU/mlµÄ¸ß²¡¶¾ÔØÁ¿ÈËȺ»®·ÖÓÐ78.1%ºÍ73.8%µÖ´ïHBV DNA<20 IU/ml£¨P=0.402£© £¬£¬£¬ £¬£¬ÓëÕûÌåÈËȺ¿¿½ü[7]¡£¡£¡£¡£¡£
5ÄêHBeAgתÒõÂÊ68%£ºÑªÇåѧת»»£¨HBeAgתÒõ/ѪÇåѧת»»£©ÊÇCHBÖÎÁƵÄÖ÷ҪĿµÄ £¬£¬£¬ £¬£¬ÊÇ×·ÇóÁÙ´²ÖÎÓúÀú³ÌÖеÄÖ÷Òª½×¶Î¡£¡£¡£¡£¡£»£»£»£»£»£»ùÏßHBeAgÑôÐÔÊÜÊÔÕßÖУ¨ÎÞÂÛ¿¹-HBeÑôÐÔ»òÒõÐÔ£© £¬£¬£¬ £¬£¬µÚ144ÖÜʱά³ÖTMFÖÎÁÆ×éÓÐ37.0%·ºÆðHBeAgתÒõ[7]£»£»£»£»£»£»5Äêʱ £¬£¬£¬ £¬£¬ÕâÒ»±ÈÀýÉý¸ßÖÁ68%[8] £¬£¬£¬ £¬£¬¸ßÓÚÆäËûͬÀàÒ©ÎïµÄ±¨¸æÊý¾Ý £¬£¬£¬ £¬£¬Îª¸ü¶à»¼ÕßʵÏÖ¡°ÁÙ´²ÖÎÓú¡±´øÀ´ÁËÏ£Íû¡£¡£¡£¡£¡£
ALT¸´³£ÂʸüÓÅ£ºµÚ96ÖÜʱ £¬£¬£¬ £¬£¬TMFÖÎÁÆ×éµÄALT¸´³£ÂʱÈTDF±ÈÕÕ×éÏÔÖøÌá¸ßÔ¼10%£¨74.4% vs 64.9% £¬£¬£¬ £¬£¬P=0.002£©[6]¡£¡£¡£¡£¡£
ºã¾ÃÓÃÒ©µÄÇå¾²ÐÔÊÇCHBÖÎÁƵĽ¹µã¹ØÇС£¡£¡£¡£¡£ºããå?ͨ¹ýÁ¢ÒìµÄÇ°ÌåÒ©ÎïÉè¼Æ £¬£¬£¬ £¬£¬ÔÚ¼á³ÖǿЧÒÖÖƲ¡¶¾µÄͬʱ £¬£¬£¬ £¬£¬ÏÔÖøÌáÉýÁ˺ã¾ÃÓÃÒ©µÄÇå¾²ÐÔ¡£¡£¡£¡£¡£
³¬80%»¼Õß¹ÇÃܶÈδϽµ£ºÓëTDFÏà±È £¬£¬£¬ £¬£¬ºããå?¶Ô¹ÇÃܶȣ¨BMD£©µÄÓ°ÏìÏÔÖø¼õС¡£¡£¡£¡£¡£¢óÆÚ48ÖÜÊý¾ÝÏÔʾ £¬£¬£¬ £¬£¬Æä÷Ų¿ºÍ¼¹ÖùBMDϽµ·ù¶ÈÏÔÖøСÓÚTDF£¨P<0.001£©[5]¡£¡£¡£¡£¡£ÕâÒ»ÓÅÊÆÔÚºã¾ÃÖÎÁÆÖеÃÒÔά³Ö£º5ÄêÑо¿Êý¾ÝÏÔʾ £¬£¬£¬ £¬£¬×ÜÌåÉÏÓÐ80.5%µÄ»¼ÕßBMD ZÆÀ·ÖÎȹ̻òÓÐÔöÌí¡£¡£¡£¡£¡£×ÝÈ»ÊÇÓÉTDFת»»ÖÁTMFÖÎÁƵĻ¼Õß £¬£¬£¬ £¬£¬Æä¹ÇÃܶÈÔÚת»»ºóÒ²»ñµÃÁ˸ÄÉÆ[9]¡£¡£¡£¡£¡£
eGFRϽµÀÛ»ý±¬·¢Âʼ«µÍ£ºÔÚÉö¹¦Ð§Ó°Ïì·½Ãæ £¬£¬£¬ £¬£¬ºããå?ͬÑùÕ¹ÏÖ³ö¸ü¼ÑµÄÇå¾²ÐÔÌØÕ÷¡£¡£¡£¡£¡£48ÖܺÍ96ÖÜÊý¾Ý¾ùÏÔʾ £¬£¬£¬ £¬£¬Æä¹ÀËãÉöСÇòÂ˹ýÂÊ£¨eGFR£©Ï½µ·ù¶ÈÏÔÖøСÓÚTDF£¨P¾ù<0.05£©[5,6]¡£¡£¡£¡£¡£5Äêºã¾ÃËæ·ÃÖÐ £¬£¬£¬ £¬£¬eGFR<60 mL/min/1.73 m?µÄÀÛ»ý±¬·¢Âʼ«µÍ£¨¡Ü0.5%£© £¬£¬£¬ £¬£¬Òâζ×ÅTMFÖÎÁÆÖоø´ó´ó¶¼»¼ÕßµÄÉö¹¦Ð§Î¬³ÖÎȹÌ[8]¡£¡£¡£¡£¡£
¶ÔѪ֬/ÌåÖØÎÞÏÔ×ÅÓ°Ï죺ÓëTDF²î±ð £¬£¬£¬ £¬£¬ºããå?¶ÔѪ֬Æ׺ÍÌåÖصÄÓ°Ïì×ÜÌå³ÊÖÐÐÔÇÒÎȹ̡£¡£¡£¡£¡£5Äêʱ´ú £¬£¬£¬ £¬£¬ÎÞÂÛά³ÖTMFÖÎÁÆ×éÕÕ¾ÉTDFתTMFÖÎÁÆ×é £¬£¬£¬ £¬£¬»¼ÕßµÄѪָ֬±êºÍÌåÖؾù¼á³ÖÎȹÌ[8]¡£¡£¡£¡£¡£
Ñо¿»¹Ì½Ë÷ÁËTDF¾Öλ¼Õßת»»ÖÁºããå?ÖÎÁƵĻñÒæ £¬£¬£¬ £¬£¬ÎªÁÙ´²ÖÎÁƼƻ®ÓÅ»¯ÌṩÁËÒÀ¾Ý¡£¡£¡£¡£¡£
ÁÆЧÌáÉý£º¢óÆÚ144ÖÜÊý¾ÝÏÔʾ £¬£¬£¬ £¬£¬TDFÖÎÁÆ96Öܺóת»»ÖÁºããå?¼ÌÐøÖÎÁÆ48ÖÜ £¬£¬£¬ £¬£¬»¼ÕßALT¸´³£ÂʽøÒ»²½ÏÔÖøÌáÉý11.4%£¨P<0.001£© £¬£¬£¬ £¬£¬ÇÒ¸ÎÏËά»¯Ö¸±ê£¨FIB-4£©»ñµÃÏÔÖø¸ÄÉÆ£¨P=0.005£© £¬£¬£¬ £¬£¬Í¬Ê±Î¬³ÖÁËÔÓеIJ¡¶¾Ñ§Ó¦´ð[7]¡£¡£¡£¡£¡£5ÄêÊý¾ÝÏÔʾ £¬£¬£¬ £¬£¬TDFתTMFÖÎÁÆ×黼ÕßͬÑùʵÏÖÁ˸ߴï94%µÄHBV DNA <20 IU/mL±ÈÀýºÍ63%µÄHBeAgתÒõÂÊ[8]¡£¡£¡£¡£¡£
¹Ç/ÉöÇå¾²ÐÔ¸ÄÉÆ£ºÇå¾²ÐÔ·½Ãæ £¬£¬£¬ £¬£¬¢óÆÚ144ÖÜÊý¾ÝÏÔʾ £¬£¬£¬ £¬£¬ÔÚ½ÓÊÜת»»ÖÎÁÆºó £¬£¬£¬ £¬£¬TDFתTMF×éµÄÉöСÇòÂ˹ýÂʺͼ¡ôûɨ³ýÂʽϵÚ96ÖÜ£¨TDFÖÎÁÆ£©»®·ÖÉý¸ß£¨2.31¡À8.33£©ml/minºÍ£¨4.24¡À13.94£©ml/min£»£»£»£»£»£»TDFתTMF×éµÄ÷Ų¿ºÍ¼¹ÖùBMD»®·Ö½ÏµÚ96ÖÜ£¨TDFÖÎÁÆ£©Éý¸ß0.75%ºÍ1.41% £¬£¬£¬ £¬£¬Åú×¢TDFת»»ÎªTMFÖÎÁƺó»¼ÕßµÄÉö¹¦Ð§ºÍ¹Ç÷ÀÇå¾²ÐÔ»ñµÃÁ˸ÄÉÆ[10]¡£¡£¡£¡£¡£
×÷ΪÒҸο¹²¡¶¾ÖÎÁƵÄÒ»ÏßÓÅÑ¡Ò©Îï £¬£¬£¬ £¬£¬ºããå?ΪCHB»¼ÕßÌṩÁÆЧÓëÇå¾²ÐÔ²¢ÖصÄÖÎÁÆÑ¡Ôñ £¬£¬£¬ £¬£¬²¢Õ¹ÏÖÁËÖйúÔÑÐÒ©ÎïÔÚÓ¦¶ÔÖØ´óÁÙ´²ÌôÕ½ÖеÄÁ¢ÒìÍ»ÆÆÓëʹÃü¼ÌÐø £¬£¬£¬ £¬£¬ÎªÍƶ¯ÊµÏÖ¡°¿µ½¡Öйú2030¡±Ïû³ý²¡¶¾ÐÔ¸ÎÑ×Σº¦µÄÕ½ÂÔÄ¿µÄТ˳Ҫº¦ÊµÁ¦¡£¡£¡£¡£¡£
²Î¿¼ÎÄÏ×£º
1.ÖлªÒ½Ñ§»á¸Î²¡Ñ§·Ö»á,ÖлªÒ½Ñ§»áѬȾ²¡Ñ§·Ö»á. ÂýÐÔÒÒÐ͸ÎÑ×·ÀÖÎÖ¸ÄÏ£¨2022Äê°æ£©[J]. Öлª¸ÎÔಡÔÓÖ¾,2022,30(12):1309-1331.
2.ÖлªÒ½Ñ§»áѬȾ²¡Ñ§·Ö»á¸ÎË¥½ßÓëÈ˹¤¸Îѧ×é,ÖлªÒ½Ñ§»á¸Î²¡Ñ§·Ö»áÖØÐ͸β¡ÓëÈ˹¤¸Îѧ×é. ¸ÎË¥½ßÕïÖÎÖ¸ÄÏ£¨2024Äê°æ£©[J]. Öлª¸ÎÔಡÔÓÖ¾,2025,33(1):18-33.
3.ÖлªÈËÃñ¹²ºÍ¹ú¹ú¼ÒÎÀÉú¿µ½¡Î¯Ô±»áÒ½Õþ˾. Ô·¢ÐԸΰ©ÕïÁÆÖ¸ÄÏ(2024Äê°æ)[J]. кÍҽѧÔÓÖ¾,2024,15(3):532-558.
4.¹ú¼ÒѬȾ²¡Ò½Ñ§ÖÐÐÄ,ÖлªÒ½Ñ§»áѬȾ²¡Ñ§·Ö»á,¡¶ÖлªÑ¬È¾²¡ÔÓÖ¾¡·±à¼Î¯Ô±»á. Öйú¸ßΣÈËȺÒÒÐ͸ÎÑײ¡¶¾ÔÙ¼¤»î·ÀÖÎÖ¸ÄÏ£¨2026Äê°æ£©[J]. ÖлªÑ¬È¾²¡ÔÓÖ¾,2025, ÍøÂçÔ¤½ÒÏþ.DOI:10.3760/cma.j.cn311365-20251118-00397
5.Liu Z, Jin Q, Zhang Y, et al. Randomised clinical trial: 48 weeks of treatment with tenofovir amibufenamide versus tenofovir disoproxil fumarate for patients with chronic hepatitis B. Aliment Pharmacol Ther. 2021 Nov;54(9):1134-1149.
6.Liu Z, Jin Q, Zhang Y, et al. 96-Week Treatment of Tenofovir Amibufenamide and Tenofovir Disoproxil Fumarate in Chronic Hepatitis B Patients. J Clin Transl Hepatol. 2023 Jun 28;11(3):649-660.
7.ÁõÖÇãü,½ðÇåÁú,ÕÅÔ¾ÐÂ,µÈ. ÑÓÉì»òת»»Îª°¬Ã×Ìæŵ¸£Î¤ÖÎÁÆÔÚÂýÐÔÒÒÐ͸ÎÑ×»¼ÕßÖеÄÁÆЧÆÀ¹À£ºÒ»Ïî¢óÆÚËæ»ú±ÈÕÕÑо¿[J]. Öлª¸ÎÔಡÔÓÖ¾,2024,32(10):883-892.
8.Zhihong Liu. 5-Year Efficacy and Safety of Tenofovir Amibufenamide(TMF) in Chronic Hepatitis B Patients with Positive or Negative HBeAg: A Multicenter, Open-label, Phase IV study. APASL 2025.OP0155
9.Zhihong Liu,et al. Influencing Factors of Bone Mineral Density Decline in Chronic Hepatitis B Patients Treated With Tenofovir Amibufenamide Over 5 Years. AASLD 2025. Abstract No.1249
10.ÁõÖÇãü,½ðÇåÁú,ÕÅÔ¾ÐÂ,µÈ. ÑÓÉì»òת»»ÖÁ°¬Ã×Ìæŵ¸£Î¤ÖÎÁÆÂýÐÔÒÒÐ͸ÎÑ×»¼ÕßµÄÇå¾²ÐÔ£ºÒ»Ïî¢óÆÚ¡¢¶àÖÐÐÄ¡¢Ëæ»ú±ÈÕÕÑо¿[J]. Öлª¸ÎÔಡÔÓÖ¾,2024,32(10):893-903.
¹ØÓÚº²ÉÖÆÒ©
ÃâÔðÉùÃ÷
Ç°Õ°ÐÔ˵Ã÷
