抗肿瘤治疗HBV复发的预防和治疗  

Prophylaxis and Therapy for Hepatitis B Virus Reactivation in Anticancer Therapy Patients

作　　者：刘芳[1] 吕秀梅[2] 

机构地区：[1]天津第三中心医院,天津300170 [2]大同市第四人民医院六病区,山西大同037008

出　　处：《山西大同大学学报（自然科学版）》2010年第1期65-68,共4页Journal of Shanxi Datong University(Natural Science Edition)

摘　　要：随着强有力的抗肿瘤细胞毒性化疗药物使用的增加,慢性乙肝病毒感染者HBV复发成为更常见的主要并发症.抗肿瘤治疗因HBV再激活导致肝炎而治疗中断,甚至出现严重的致命性的肝衰竭,预后极差.拉米夫定已证实具有确切的抗病毒作用,对恶性肿瘤化疗后HBV复发患者,应用拉米夫定也可有效控制HBV复制,建议化疗期间尚未见ALT升高,而HBV-DNA显现最初升高而未观察到肝细胞损伤时即开始使用拉米夫定.对于需要化疗的患者,预防HBV复发的出现则是一个更为实际可行的办法,但仍需要密切的临床监测.With the more widespread use of chemotherapy in HBV （＋）patients, the possibility of HBV reactivation is becoming an clinically increasing problem and significant complication that may adversely affect the final outcome of treatment in patients receiving chemotherapy. The condition may result in varying degrees of liver damage, causing the chemotherapy disruption. Reactivation of HBV is a serious cause of hepatic failure and death in patients undergoing cytotoxie therapy. It compromises the patients＇ prognosis. Recent reports have suggested that the anti-viral agent, lamivudine, may be effective in controlling viral replication during HBV reactivation. Lamivudine was administered during the course of the rise in HBV-DNA preceded that of ALT. A better strategy might be to use anti-viral agent prophylaxis before the eytotoxic chemotherapy and hence to prevent the enhancement of HBV reactivation during the early chemotherapy period. But potential intense monitoring may be need.

关 键 词：HBV复发 抗肿瘤治疗 细胞毒性化疗 

分 类 号：R730.1[医药卫生—肿瘤]