一线核子侧面类似物对慢性乙型肝炎患者的脂质特征的影响:一个网络元分析
Kexin Tong1, Mingjing Chen1, Danni Wang1
1Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
European journal of clinical pharmacology
|January 10, 2024
概括
诺福维尔双醇 (TDF) 有效地降低了慢性乙型肝炎 (CHB) 患者的脂质,特别是老年人. 恩特卡维尔 (ETV) 和天诺福维尔阿拉芬胺 (TAF) 对脂质谱表现出中性作用.
科学领域:
- 肝病学和病毒性肝炎的研究研究.
- 药理学和治疗学 药理学和治疗学
- 慢性疾病中的心血管风险评估
背景情况:
- 慢性乙型肝炎 (CHB) 的抗病毒疗法可以影响患者的脂质谱.
- 了解这些脂质变化对于管理CHB患者的长期健康结果至关重要.
- 第一线核类同类 (NA) 是CHB的标准治疗方法.
研究的目的:
- 评估一线核类同类 (NA) 对CHB患者的脂质谱的影响.
- 为了比较恩特卡维尔 (ETV),诺福维尔二醇烟酸 (TDF) 和诺福维尔阿拉芬胺 (TAF) 对脂质水平的影响.
- 进行网络元分析,以全面评估NA对脂质的疗效.
主要方法:
- 在七个电子数据库 (PubMed,Embase,Cochrane图书馆和四个中国数据库) 进行系统的文献搜索,直到2023年8月1日.
- 包括考察NA治疗对血清总胆固醇 (TC),甘油三 (TG),LDL-C和CHB患者的HDL-C的影响的队列研究.
- 使用频率学框架的网络元分析,使用RevMan 5.4和Stata 16.0软件计算平均差异 (MD) 和95%置信区间 (CI).
主要成果:
- 总共分析了4194名患者,比较ETV,TDF,TAF,不活跃的CHB患者和非HBV感染的个人.
- 与非抗病毒组相比,诺福维尔双醇 (TDF) 显著降低了TC水平 (MD = -17.27与非活性CHB相比;MD = -17.10与非HBV相比).
- 在NA中,TDF在降低TG,LDL-C和HDL-C方面显示出最显著的效果,在50岁及以上的患者中具有明显的效果.
结论:
- 诺福维尔二氧化 fumarate (TDF) 有效降低脂质水平,特别是在老年CHB患者中.
- 诺福维尔阿拉芬胺 (TAF) 和恩特卡维尔 (ETV) 对TC,TG,LDL-C和HDL-C表现出中性作用.
- 在从TDF过渡到TAF或ETV期间的脂质水平变化处于可接受的范围内.
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