乙型肝炎病毒感染率在多发性骨髓瘤及健康体检人群的病例对照研究  

A case-control study of hepatitis B virus infection in multiple myeloma patients and healthy controls

作　　者：王立茹[1] 陈以娟[1] 李星[1] 郭天娇[1] 李茜[1] 路瑾[2] 黄晓军[2] 

机构地区：[1]首都医科大学附属复兴医院,北京市100038 [2]北京大学人民医院,北京大学血液病研究所

出　　处：《中国肿瘤临床》2014年第13期836-839,共4页Chinese Journal of Clinical Oncology

基　　金：国家自然科学基金面上项目(编号:81372535);北京大学创新药物研究开发技术平台建设项目(编号:2012ZX09303019)资助~~

摘　　要：目的:比较乙型肝炎病毒(HBV)在多发性骨髓瘤(MM)患者中的感染率有无增加,及合并HBV感染MM患者的临床特征。方法:以363例MM患者为研究对象,同时期11 227例健康体检者为对照组。采用免疫发光法检测HBV血清学标志物,实时定量聚合酶链反应检测HBV-DNA。比较HBsAg阳性和HBsAg阴性MM患者的临床特征及OS。结果:化疗前16例(4.4%)MM患者HBsAg阳性,高于同期健康体检者(2.4%,P=0.015)。HBsAg阳性与HBsAg阴性MM患者相比,两组MM患者的总生存期无显著差别。2例接受含硼替佐米和地塞米松方案治疗的HBsAg阳性患者化疗后出现肝功异常和HBV再激活,应用抗乙肝药物可以抑制其HBV复制。结论:MM患者具有较体检人群高的HBV感染率,在治疗过程中需要密切监测HBsAg阳性患者的HBV复制并予以抗乙肝治疗。Objective： To explore the prevalence of hepatitis B virus （HBV） in multiple myeloma （MM） patients, as well as to compare the clinical characteristics and outcome between HBV infected and non-HBV infected patients. Methods： The serology markers of HBV were detected in 363 MM patients and 11227 cases of healthy controls through chemiluminescence. HBV-DNA was measured via real-time quantitative chain reaction. Results： Sixteen out of 363 MM patients （4.4%） were HBsAg-positive, showing significant difference with healthy controls （2.4%）. No statistically significant differences were observed in terms of sex, age, type of monoclonal （M） protein, International Staging System （ISS） stage, stem cell transplantation, and risk stratification between HBsAg-positive and HBsAg-negative patients. No significant effect of HBV infection was found on the OS of MM patients. HBV reactivation was observed in two HBsAg-positive MM patients who were treated with combination chemotherapy, including bortezomib and dexamethasone. The replication of HBV could be inhibited by anti-HBV drugs. Conclusion： A higher prevalence of HBV infection was revealed in MM patients. Close monitoring of HBV replication should be conducted in MM patients with HBV infection before and during the courses of chemotherapy.

关 键 词：多发性骨髓瘤 乙型肝炎病毒 化疗 再激活 硼替佐米 

分 类 号：R733.3[医药卫生—肿瘤]