【摘要】 目的:探讨AS伴HBV携带患者接受TNF拮抗剂治疗的肝脏安全性问题。方法:回顾性分析曾在中山大学附属第三医院接受TNF拮抗剂治疗的AS伴HBV携带患者随访期间的临床资料、HBV DNA水平和肝酶学变化情况。结果:共有10例患者分别使用依那西普或英夫利昔单抗治疗,其中停药3例。5例患者曾出现HBV DNA水平升高,其中停药2例。5例患者曾出现不同程度肝酶学异常,其中停药3例。4例患者同时出现肝酶学异常和HBV DNA水平升高,其中停药2例。随访结束时所有患者HBV DNA水平、肝酶学均处于正常范围,未出现严重肝损害或死亡病例。结论:AS合并HBV携带患者应用TNF拮抗剂安全、有效,但需密切监测肝功能和HBV DNA水平。更多还原

【Abstract】 Objective:To evaluate the liver safety of tumor necrosis factor(TNF) antagonist therapy in Hepatitis B carriers with ankylosing spondylitis.Methods:Follow-up records of Hepatitis B carriers with ankylosing spondylitis during the therapy of TNF antagonist were analyzed retrospectively,with focus on hepatitis B viral load and liver enzymes.Results:Ten patients received treatment of yisaipu and/or infliximab while anti-TNF therapy was withdrawn in 3 patients.TNF antagonist was withdrawn in 2 out of 5 patients with elevated Hepatitis B viral load,3 out of 5 patients with elevated liver enzymes,and 2 out of 4 patients with both elevated Hepatitis B viral load and liver enzymes.No elevated AST,ALT or Hepatitis B viral loads,serious impairment of liver function or death was recorded at the end the study. Conclusion:Anti-TNF treatment in hepatitis B virus carriers with ankylosing spondylitis is safe and effective if iver function and Hepatitis B virul DNA level are closely monitored.更多还原