腫瘤患者化療時(shí)乙肝病毒的再激活及核苷類藥物的預(yù)防作用
發(fā)布時(shí)間：2018-11-11 13:43
【摘要】：目的：探討HBsAg陽性的惡性腫瘤患者化療時(shí)HBV的再激活及核苷類藥物的預(yù)防作用. 方法：分析在我院進(jìn)行化療且資料完整的惡性腫瘤患者2253例,篩選其中HBsAg陽性且肝功能正常的患者125例,其中88例僅單獨(dú)給予化療(對照組),37例化療前1周給予核苷類藥物治療(治療組).比較兩組化療后HBV再激活、肝功、肝炎復(fù)發(fā)及化療延遲等的差異. 結(jié)果：化療前879例患者進(jìn)行了HBV血清學(xué)檢測(39.0%).肺癌及乳腺癌的檢測率,分別為217例(53.8%)及181例(51.9%)。125例HBsAg陽性患者中47例(37.6%)出現(xiàn)肝炎復(fù)發(fā),其中治療組和對照組分別為7例和40例(18.9%vs45.5%,P=0.008),重度肝炎在治療組和對照組分別為2例和19例(5.4%vs21.6%,P=0.035),輕、中度肝炎兩組比較無統(tǒng)計(jì)學(xué)意義(P0.05).17例(13.6%)。治療組化療后ALT、AST、 HBVDNA明顯低于對照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)�；熀罂偰懠t素兩組無明顯差異(P0.05)。患者出現(xiàn)HBV再激活,治療組和對照組分別為1例和16例(2.7%vs18.2%,P=0.022).延遲化療在治療組和對照組分別為3例和29例(8.1%vs33.0%,P=0.003).共5例患者死亡,治療組1例,對照組3例,與HBV再激活相關(guān)1例,余為疾病進(jìn)展導(dǎo)致死亡。 結(jié)論：腫瘤患者化療前應(yīng)進(jìn)行HBV感染篩查。預(yù)防性的抗病毒治療能顯著降低HBsAg陽性的腫瘤患者化療時(shí)HBV的再激活,有助于減少化療延遲.
[Abstract]:Objective: to investigate the reactivation of HBV and the preventive effect of nucleoside drugs on HBsAg positive malignant tumor patients. Methods: 2253 patients with malignant tumor underwent chemotherapy in our hospital were analyzed. Among them, 125 patients with HBsAg positive and normal liver function were selected, 88 of them were treated with chemotherapy alone (control group). 37 cases were treated with nucleoside drugs one week before chemotherapy (treatment group). HBV reactivation, liver function, recurrence of hepatitis and delayed chemotherapy were compared between the two groups. Results: HBV serological examination was performed in 879 patients (39.0%) before chemotherapy. The detection rates of lung cancer and breast cancer were 217 (53.8%) and 181 (51.9%) respectively. There were 7 cases in the treatment group and 40 cases in the control group (18.9vs45.5), 2 cases in the treatment group and 19 cases in the control group (5.4vs21.6%). There was no significant difference in moderate hepatitis between the two groups (P0.05). 17 cases (13.6%). The ALT,AST, HBVDNA in the treatment group was significantly lower than that in the control group after chemotherapy (P0.05). There was no significant difference in total bilirubin between the two groups after chemotherapy (P0.05). HBV reactivation was found in 1 case in the treatment group and 16 cases in the control group (2.7 vs 18.2). There were 3 cases in the treatment group and 29 cases in the control group (8.1 vs 33.0). A total of 5 patients died, 1 case in the treatment group and 3 cases in the control group, and 1 case was associated with HBV reactivation. Conclusion: cancer patients should be screened for HBV infection before chemotherapy. Prophylactic antiviral therapy can significantly reduce the reactivation of HBV during chemotherapy in patients with HBsAg positive tumors and help reduce the delay of chemotherapy.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R512.62
本文編號：2325002
[Abstract]:Objective: to investigate the reactivation of HBV and the preventive effect of nucleoside drugs on HBsAg positive malignant tumor patients. Methods: 2253 patients with malignant tumor underwent chemotherapy in our hospital were analyzed. Among them, 125 patients with HBsAg positive and normal liver function were selected, 88 of them were treated with chemotherapy alone (control group). 37 cases were treated with nucleoside drugs one week before chemotherapy (treatment group). HBV reactivation, liver function, recurrence of hepatitis and delayed chemotherapy were compared between the two groups. Results: HBV serological examination was performed in 879 patients (39.0%) before chemotherapy. The detection rates of lung cancer and breast cancer were 217 (53.8%) and 181 (51.9%) respectively. There were 7 cases in the treatment group and 40 cases in the control group (18.9vs45.5), 2 cases in the treatment group and 19 cases in the control group (5.4vs21.6%). There was no significant difference in moderate hepatitis between the two groups (P0.05). 17 cases (13.6%). The ALT,AST, HBVDNA in the treatment group was significantly lower than that in the control group after chemotherapy (P0.05). There was no significant difference in total bilirubin between the two groups after chemotherapy (P0.05). HBV reactivation was found in 1 case in the treatment group and 16 cases in the control group (2.7 vs 18.2). There were 3 cases in the treatment group and 29 cases in the control group (8.1 vs 33.0). A total of 5 patients died, 1 case in the treatment group and 3 cases in the control group, and 1 case was associated with HBV reactivation. Conclusion: cancer patients should be screened for HBV infection before chemotherapy. Prophylactic antiviral therapy can significantly reduce the reactivation of HBV during chemotherapy in patients with HBsAg positive tumors and help reduce the delay of chemotherapy.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R512.62
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相關(guān)期刊論文 前3條
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，本文編號：2325002
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