目的 探討替比夫定治療乙型肝炎病毒相關(guān)性腎炎（HBV-GN）的臨床療效。方法 2011年10月—2013年6月西電集團(tuán)醫(yī)院收治的HBV-GN患者64例，隨機(jī)分為治療組（32例）和對(duì)照組（32例）。兩組患者均給與相應(yīng)的對(duì)癥治療，對(duì)照組口服拉米夫定片，1片/次，1次/d。治療組在對(duì)癥治療基礎(chǔ)上口服替比夫定片，1片/次，1次/d。所有患者均連續(xù)治療12個(gè)月。治療后，對(duì)兩組的臨床療效進(jìn)行評(píng)價(jià)，同時(shí)對(duì)其肝腎指標(biāo)進(jìn)行檢測(cè)。結(jié)果 治療組和對(duì)照組的總有效率分別為90.63%、68.75%，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療6個(gè)月、治療后兩組患者丙氨酸氨基轉(zhuǎn)氨酶（ALT）、天冬氨酸氨基轉(zhuǎn)氨酶（AST）、總膽紅素（STB）、尿素氮（BUN）、血肌酐（Scr）、尿蛋白/肌酐比（Up/cr）均較治療前顯著降低，腎小球?yàn)V過(guò)率（GFR）、血清白蛋白（Alb）均較治療前顯著升高，同組治療前后差異有統(tǒng)計(jì)學(xué)意義（P<0.05），且治療組各指標(biāo)的改善程度優(yōu)于對(duì)照組，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。替比夫定對(duì)各種HBV-GN均有較好的臨床療效，總有效率均在75%以上，其中對(duì)于局灶階段性腎小球硬化癥和硬化性腎小球腎炎的治療效果最好，總有效率高達(dá)100%。結(jié)論 替比夫定治療HBV-GN有較好的臨床療效，可改善疾病相關(guān)指標(biāo)，值得推廣應(yīng)用。

Objective To investigate the clinical efficacy of telbivudine in the treatment of hepatitis B virus associated glomendonephritis (HBV-GN). Methods Sixty four patients with HBV-GN in Xi'an XD Group Hospital from October, 2011 to June, 2013 were randomly divided into control (32 cases) and treatment (32 cases) groups, and all the patients were given corresponding symptomatic treatment. Patients in the control group were po administered with Lamivudine Tablets, 1 piece/time, once daily. Patients in the treatment group were po administered with Telbivudine Tablets on the basis of symptomatic treatment, 1 piece/time, once daily. After the treatment, the treatment efficacy was evaluated, while the indexes of liver and kidney were tested. Results The efficacies in the treatment and control groups were 90.63% and 68.75%, respectively, and there were differences between the two groups (P < 0.05). The treatment for 6 months, after the treatment, ALT, AST, STB, BUN, Scr, and Up/cr in the two groups were significantly reduced, while GFR and Alb were elevated, and there was significant difference compared with those before the treatment in the same group (P < 0.05). And these observational indexes in the treatment group were improved better than those in the control group, and there was significant difference between the two groups (P < 0.05). Telbivudine had better clinical curative effect in the treatment of all kinds of HBV-GN, and total effective rate was over 75%. Telbivudine had the best treatment effect for focal periodic glomerular sclerosis and sclerosing glomerulonephritis, and the total effective rate was up to 100%. Conclusion Telbivudine has a good clinical effect in the treatment of HBV-GN and could improve disease-related indicators, which is worthy of clinical application.