中国实用外科杂志

中国实用外科杂志

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肝移植病人服用替比夫定后并发肌病和周围神经病3例分析

汪根树a，李敏如a，李学俊b，李    华a，姜    楠a，汪国营a，傅斌生a，张    剑a，杨    杨a，陈规划a   

  1. 中山大学附属第三医院 中山大学器官移植研究所 广东省器官移植中心 a.肝脏移植中心  b.肝病内科，广东广州510630
  • 发布日期:2012-01-18

  • Published:2012-01-18

摘要：

目的    探讨肝移植病人服用替比夫定后并发肌病（myopathy，MP）和周围神经病（peripheral neuropathy，PNP）的诊治方法。 方法    回顾分析2008年6月至2009年6月中山大学附属第三医院3例肝移植病人服用替比夫定后并发MP和PNP的临床特点及诊治过程。  结果    应用替比夫定的肝移植病人MP和PNP发生率为11.5%（3/26），出现症状时间平均为用药后11.7个月，诊断时间平均为出现症状后10.7个月，治疗后平均3个月临床症状基本消失。 结论    肝移植病人同时服用替比夫定和他克莫司时MP和PNP的发生率较高，应注意观察其相关症状，监测血肌酸磷酸激酶和肌红蛋白，以便早期诊断和治疗MP和PNP。

关键词: 替比夫定, 肌病, 周围神经病, 肝移植

Abstract:

Diagnosis and therapy of myopathy and peripheral neuropathy complicated with liver transplant recipients who administered telbivudine:an analysis of 3 cases        WANG Gen-shu*, LI Min-ru, LI Xue-jun, et al. *Organ Transplantation Institute, Sun Yat-sen University; Liver Transplantation Center, Affiliated Third Hospital, Sun Yat-sen Universiy, Guangzhou 510630, China
Corresponding author: CHEN Gui-hua,E-mail: chgh1955@263.net
Abstract    Objective    To investigate the diagnosis and therapy of myopathy(MP) and peripheral neuropathy(PNP) complicated with liver transplant recipients who administered telbivudine. Methods    The clinic featuers and treatments of MP and PNP after administering telbivudine in three patients who received liver transplantation from June 2008 to June 2009 in  Affiliated Third Hospital of Sun Yat-sen University were investigated retrospectively. Results    The incidence of MP and PNP among the liver transplant recipients who administered telbivudine was 11.5% (3/26). The average time from taking telbivuding to appearing symptoms of MP and PNP was 11.7 months. The average time from appearing symptoms to diagnosis was 10.7 months. The manifestation disappeared 3 months after treatment. Conclusion Liver transplant recipients who administer telbivudine and tacrolimus meantime have a relatively high incidence of MP and PNP. In order to early diagnose and treat MP and PNP, attention should be paid to observe related manifestations of MP and PNP and monitor serum creatine kinase and myoglobin.

Key words: telbivudine, myopathy, peripheral neuropathy, liver transplantation