本文报道1例慢性乙型肝炎患者服用阿德福韦酯后发生 Fanconi 综合征。患者的临床症状出现时间与服用阿德福韦酯时间平行、而在停用阿德福韦酯并补充枸橼酸钾后临床症状缓解，诊断为阿德福韦酯相关 Fanconi 综合征。复习文献发现，阿德福韦酯治疗导致的 Fanconi 综合征存在剂量依赖性、时间依赖性及可逆性，其中小剂量阿德福韦酯(10 mg/d)治疗慢性乙型肝炎后出现 Fanconi 综合征的均为亚裔人群。因此，凡服用阿德福韦酯的患者，无论剂量大小，均需定期进行相关检查，以监测是否发生 Fanconi 综合征。一旦发生，应立即换用其他抗病毒药物。%This paper reports a case of Fanconi’s syndrome with a history of taking adefovir dipivoxil for treatment of chronic hepatitis B. The occurrence time of the clinical symptoms of patient was consistent with the start time of taking adefovir dipivoxil. Besides, the symptoms were released after the stop of taking the drug and supplement of potassium citrate so that a diagnosis of Fanconi’s syndrome associated with adefovir dipivoxil was made. The literatures were reviewed and it was found that this syndrome treated with adefovir dipivoxil was dose-dependent, time-dependent and reversible. All reported cases of Fanconi’s syndrome caused by a small dose of adefovir dipivoxil (10 mg/d) to treat hepatitis B occurred in Asian population. Therefore, it is suggested that all those who take adefovir dipivoxil, regardless of the dose, should regularly have a relevant check-up and monitor whether Fanconi’s syndrome occurs or not. If so, it should be replaced by other antivirus drugs.
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