| Background and ObjectiveThe treatment of chronic hepatitis B（CHB）is a worldwide public health problem-nucleoside（acid）analogues such asLamivudine,Adefovir dipivoxil,Entecavir,Telbivudine and Tenofovir Disoproxil fumarate and other nucleoside（acid）analogues,its strong antiviral effect and better tolerance has been widely clinical Application,however,because the anti-HBV treatment is long（the vast majority of patients may need to take for life）,and the advantages and disadvantages are different,it must still pay attention to its safety issues.In addition,With the rapid development of a large number of oral medications and the rapid development of academic fields,the World Health Organization’s Guide to Prevention,Care and Treatment of Chronic HBV Infection in March 2015 recommended the preferred high-resistance barrier to tenofovir and entecavir as first-line resistance Treatment of chronic hepatitis B with viral drugs.Because of oral anti-HBV drugs in the human body through the kidney metabolism,This study monitors dynamically and compares renal function（glomerular filtration rate,β2-microglobulin,cystatin C,etc.）changes in patients with CHB alone with tenofovir or entecavir,and and compared to further assess the early renal function damage,in order to provide clinical data for the safety of anti-HBV drugs,and discuss the drugs safety.MethodsA total of 61 previously untreated CHB patients who were diagnosed and treated in the Department of Infectious Diseases in Henan Provincial People’s Hospital from June 2013 to August 2015 were enrolled and divided into tenofovir group and entecavir group.The levels of liver function,25-hydroxyvitamin D3（25（OH）D3）,serum calcium,serum phosphorus,HBV-DNA and HBeAg positive rates were compared in all patients,andThe serum levels of β2-microglobulin,retinol-binding protein,cystatin C,and creatinine and estimated glomerular filtration rate（eGFR）were compared between the two groups at baseline and 4,8,39,52,78,and 104 weeks after antiviral therapy.The application of SPSS statistical software to analyze data,P < 0.05 was considered statistically significant.Results61 CHB patients were enrolled,with 31 in the tenofovir group and 30 in the entecavir group.There was no significant difference in the levels of 25-hydroxyvitamin D3,serum calcium and serum phosphorus between the two groups at baseline（P>0.05）.The two groups had comparable serum levels of β2-microglobulin,retinol-binding protein,and cystatin C at baseline,but there were significant differences in β2-microglobulin and retinol-binding protein over time（both P < 0.05）.There was a significant difference in cystatin C at 78 weeks（t =-2.062,P = 0.044）,but there was no significant difference at 104 weeks（t =-1.544,P= 0.128）.There were no significant differences in serum creatinine or eGFR at any time point between the two groups（P>0.05）.At 104 weeks,there were no significant differences in HBV-DNA clearance rate or the level of virologic breakthrough between the two groups（P > 0.05）.ConclusionSerum β2-microglobulin,retinol binding protein,and cystatin C are more sensitive than eGFR in the monitoring of early renal dysfunction during the anti-HBV therapy with first-line drugs（tenofovir or entecavir alone）;if the three launched a joint test,can play a role in the gap,it is worthy of clinical recommendations. |
