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1例31岁女性患者,因慢性乙型病毒性肝炎给予替比夫定600mg,1次/d。持续治疗10个月后加用干扰素300万U,隔日1次皮下注射。9个月后,停用干扰素,替比夫定继续使用。患者出现下肢麻木,进行性加重。随后出现明显肌痛,下肢无力,感觉异常。查体:四肢末梢型痛觉稍减退,双下肢腱反射减弱,下肢末端皮肤稍苍白,左足拇趾甲灰变。实验室检查:CK1694.3U/L。运动神经传导速度检查显示左腓总神经远端潜伏期延长,波幅减低;感觉神经传导速度检查显示左胫神经传导速度偏慢。停用替比夫定,改用拉米夫定,并给予维生素B1及辅酶Q10口服。2个月后症状好转。
One 31-year-old female patient received telbivudine 600 mg once daily for chronic hepatitis B. 10 months after treatment with interferon plus 3 million U, 1 subcutaneous injection every other day. After 9 months, disable interferon, telbivudine continue to use. Patients with lower limb numbness, progressive increase. Followed by significant muscle pain, weakness in the legs, feeling abnormalities. Physical examination: peripheral extremity pain relief slightly diminished lower extremity tendon reflexes, the lower extremity of the skin slightly pale, left foot toe gray ash change. Laboratory examination: CK1694.3U / L. Motor nerve conduction velocity examination showed prolonged left distal peroneal nerve latency, amplitude decreased; sensory nerve conduction velocity examination showed slow tibial nerve conduction velocity. Disable telbivudine, switch to lamivudine, and given vitamin B1 and coenzyme Q10 orally. After 2 months, the symptoms improved.