本文選題：化療 + 乙型肝炎��； 參考：《廣東醫(yī)學(xué)》2015年07期

【摘要】：目的探討腫瘤患者中拉米夫定耐藥情況及耐藥相關(guān)肝炎活動。方法收集住院接受化療并使用拉米夫定預(yù)防性抗病毒治療的患者72例臨床資料。所有患者化療前及化療計(jì)劃完成后定期檢測HBV DNA及肝功能情況�；颊呔凑誑CCN指南進(jìn)行化療,抗病毒治療方案為口服拉米夫定0.1 g/d,主要終點(diǎn)為病毒突破及乙型肝炎病毒再活動(病毒突破導(dǎo)致肝炎活動)。分析拉米夫定耐藥率及耐藥相關(guān)肝炎活動。結(jié)果入組的72例患者化療前肝功能均為Child-Pugh A級,HBV DNA陽性46例。拉米夫定使用41.4(5.4~217)周。化療前HBV DNA定量陽性的患者中,達(dá)到病毒完全應(yīng)答30例(65.2%),出現(xiàn)病毒突破8例(11.1%)。發(fā)生乙型肝炎病毒再活動3例,并且1例患者死于肝炎活動所致的急性肝衰竭。另外5例長期隨訪,未見肝炎活動。結(jié)論腫瘤患者中拉米夫定仍有一定的耐藥率,需嚴(yán)密監(jiān)測病毒載量并及時處理病毒耐藥。
[Abstract]:Objective to investigate the drug resistance of lamivudine and the activity of resistant hepatitis in tumor patients. Methods 72 patients who received chemotherapy and received lamivudine prophylactic antiviral therapy were collected. HBV DNA and liver function were measured before and after chemotherapy. All patients were treated with chemotherapy according to NCCN guidelines. The antiviral therapy regimen was oral lamivudine 0.1 g / d. The main endpoints were viral breakthrough and hepatitis B virus reactivity (viral breakthrough led to hepatitis activity). To analyze the drug resistance rate of lamivudine and the activity of hepatitis associated with drug resistance. Results the liver function of 72 patients before chemotherapy was Child-Pugh A DNA positive in 46 cases. Lamivudine was used for 41.4 / 5.4 / 217) weeks. In the patients with positive HBV DNA before chemotherapy, 30 cases had complete response to the virus, and 8 cases had the virus breaking through 11. 1%. Hepatitis B virus reactivity occurred in 3 cases, and one patient died of acute liver failure due to hepatitis activity. The other 5 cases were followed up for a long time without hepatitis activity. Conclusion Lamivudine still has a certain drug resistance rate in tumor patients, so it is necessary to monitor the viral load and deal with the drug resistance in time.
【作者單位】： 中山大學(xué)附屬第三醫(yī)院腫瘤內(nèi)科;廣州醫(yī)科大學(xué)附屬第三醫(yī)院超聲科;廣州醫(yī)科大學(xué)附屬第三醫(yī)院腎內(nèi)科;
【基金】：國家自然科學(xué)基金面上項(xiàng)目(編號:81372374)
【分類號】：R512.62

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本文編號：1876740