肿瘤患者化疗时乙肝病毒的再激活及核苷类药物的预防作用
发布时间：2018-11-11 13:43
【摘要】：目的：探讨HBsAg阳性的恶性肿瘤患者化疗时HBV的再激活及核苷类药物的预防作用. 方法：分析在我院进行化疗且资料完整的恶性肿瘤患者2253例,筛选其中HBsAg阳性且肝功能正常的患者125例,其中88例仅单独给予化疗(对照组),37例化疗前1周给予核苷类药物治疗(治疗组).比较两组化疗后HBV再激活、肝功、肝炎复发及化疗延迟等的差异. 结果：化疗前879例患者进行了HBV血清学检测(39.0%).肺癌及乳腺癌的检测率,分别为217例(53.8%)及181例(51.9%)。125例HBsAg阳性患者中47例(37.6%)出现肝炎复发,其中治疗组和对照组分别为7例和40例(18.9%vs45.5%,P=0.008),重度肝炎在治疗组和对照组分别为2例和19例(5.4%vs21.6%,P=0.035),轻、中度肝炎两组比较无统计学意义(P0.05).17例(13.6%)。治疗组化疗后ALT、AST、 HBVDNA明显低于对照组,差异有统计学意义(P0.05)。化疗后总胆红素两组无明显差异(P0.05)。患者出现HBV再激活,治疗组和对照组分别为1例和16例(2.7%vs18.2%,P=0.022).延迟化疗在治疗组和对照组分别为3例和29例(8.1%vs33.0%,P=0.003).共5例患者死亡,治疗组1例,对照组3例,与HBV再激活相关1例,余为疾病进展导致死亡。 结论：肿瘤患者化疗前应进行HBV感染筛查。预防性的抗病毒治疗能显著降低HBsAg阳性的肿瘤患者化疗时HBV的再激活,有助于减少化疗延迟.
[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.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R512.62
本文编号：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.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R512.62
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，本文编号：2325002
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