HBsAg阳性肺癌患者化疗后肝损害的临床分析  

Clinical analysis of chemotherapy increases the risk of hepatic toxicity in hepatitis B virus antigen positive patients with lung cancer

作　　者：罗洁[1] 郑迪[1] 周彩存[1] 

机构地区：[1]上海市肺科医院肿瘤科

出　　处：《临床肿瘤学杂志》2005年第3期249-251,共3页Chinese Clinical Oncology

摘　　要：目的:研究HBV与肺癌化疗后肝损害的关系。方法:回顾性收集了从2002年1月～2004年1月,在我院接受含铂方案化疗的肺癌患者950例,比较HBsAg阳性患者和HBsAg阴性患者化疗前后肝功能变化情况,以及与使用激素作预处理的关系。结果:HBsAg阳性肺癌患者接受化疗时,较HBsAg阴性患者更易发生肝损害(19.6%vs9.4%,P<0.001),且Ⅲ～Ⅳ度肝损害比例较高(10.8%vs2.8%,P<0.001);HBsAg阳性曾用激素作预处理的患者,其肝损害发生率显著高于HB sAg阴性且曾用激素作预处理的病例(24.6%vs10.1%,P<0.001)。结论:HBsAg阳性肺癌患者较HBsAg阴性患者而言,化疗后更易发生肝损害,且肝损害发生时间早、程度重;类固醇激素的应用可以诱发肝损害。Objective:To investigate the relation between HBV and hepatic toxicity during chemotherapy.Methods:950 lung cancer patients diagnosed during the period 2002 to 2004 were identified using the Shanghai Pulmonology Hospital tumor registry. Medical records were reviewed to confirm study eligibility and to obtain data on hepatic toxicity with or without HBV infection and association to steroids pretreatment.Results:As expected a positive HBsAg is associated with a greater risk of hepatic toxicity (19.6% vs 9.4%, P<0.001), moreover, 3-4 grade hepatic toxicity is more (10.8% vs 2.8%, P<0.001). HBsAg-positive patient receiving steroid-containing premedication for chemotherapy had higher rate of hepatotoxicity than those with HBsAg-negative (24.6% vs 10.1%, P<0.001).Conclusion:HBV infection is associated with higher risk of hepatic toxicity in patients with lung cancer during chemotherapy, steroids pretreatment may cause hepatic toxicity.

关 键 词：HBV 肺癌 化疗 肝损害 化疗 临床分析 

分 类 号：R734.2[医药卫生—肿瘤]