核苷类似物防治化疗后乙肝病毒再激活的临床疗效分析

发布时间：2018-05-09 00:13

本文选题：肝炎病毒 + 乙型　；参考：《中国新药与临床杂志》2015年07期

【摘要】：目的回顾性分析核苷类似物(NAs)对恶性肿瘤合并慢性乙肝病毒(HBV)携带者化疗后HBV再激活的治疗效果及化疗前抗病毒用药对HBV再激活的预防作用。方法收集2006年1月 2011年12月本院住院肿瘤患者中进行细胞毒性药物化疗的非活动性乙肝表面抗原(HBsAg)携带者病例。对照组为规范细胞毒性药物化疗,观察化疗后乙肝病毒活跃情况和肝功能损害;预防组在化疗前1~2周使用NAs,根据具体情况持续使用NAs 6~12月,观察HBV再激活的情况和临床表现。结果共收集227例患者,化疗期间共出现67例(29.5%)HBV再激活。对照组102例患者中56例(54.9%)出现HBV再激活,其中19例患者发展为重型肝炎,9例死亡,2例转至外院行活体肝移植;预防组125例患者在使用NAs后有11例(8.8%)出现HBV再激活,其中5例发展为重型肝炎,2例死亡。两组再激活发生率有非常显著差异(χ2=57.4,P0.001)。结论恶性肿瘤合并非活动性HBsAg携带者在接受细胞毒性药物化疗前应及时使用NAs抗病毒治疗,以减少HBV再激活的发生,从而改善临床预后。
[Abstract]:Objective to retrospectively analyze the therapeutic effect of nucleoside analogue (Nas) on HBV reactivation after chemotherapy in patients with malignant tumor complicated with chronic hepatitis B virus (HBV) and the preventive effect of antiviral drugs before chemotherapy on HBV reactivation. Methods Non-active hepatitis B surface antigen HBsAg carriers who received cytotoxic drug chemotherapy in our hospital from January 2006 to December 2011 were collected. In the control group, the activity of hepatitis B virus and the liver function damage were observed after chemotherapy, and the HBV reactivation and clinical manifestation were observed in the prevention group after 12 weeks of chemotherapy and 6 ~ 12 months of continuous administration of NAs according to the specific conditions. Results A total of 227 patients were collected, 67 cases of HBV reactivation occurred during chemotherapy. In the control group, HBV reactivation occurred in 56 patients (54.9%), in which 19 patients developed severe hepatitis and 9 died and 2 patients were transferred to the non-hospital for living donor liver transplantation, while in the prevention group, HBV reactivation occurred in 11 patients after NAs administration. Among them, 5 cases developed severe hepatitis and 2 died. There was a significant difference in the incidence of reactivation between the two groups (蠂 2, 57.4, P 0.001). Conclusion NAs antiviral therapy should be used in patients with malignant tumor complicated with inactive HBsAg before chemotherapy with cytotoxic drugs in order to reduce the occurrence of HBV reactivation and improve the clinical prognosis.
【作者单位】：重庆医科大学附属永川医院感染科;重庆医科大学附属永川医院消化内科;重庆医科大学附属第一医院感染科;
【基金】：重庆市卫生局医学科研面上项目(2012-2-177) 重庆市永川科委软科学项目(YCSTC,2012BE5009) 重庆医科大学附属永川医院科研项目(YJYB2011016)
【分类号】：R512.62

【相似文献】