HBV DNA拷贝数对乙型肝炎肿瘤患者化疗联合抗病毒治疗结果的影响  

Impact of HBV DNA copies on clinical effects of chemotherapy combined with antiviral therapy in tumor patients with hepatitis B

作　　者：陈莉林[1] 林东旭[1] 曾茹[1] 安汗祥 

机构地区：[1]厦门大学附属第一医院肿瘤内科,福建省厦门市361001

出　　处：《世界华人消化杂志》2014年第32期4985-4990,共6页World Chinese Journal of Digestology

摘　　要：目的:分析实体瘤患者化疗期间乙型肝炎病毒(hepatitis B virus,HBV)DNA的活化情况,了解初始不同HBV拷贝数患者之间化疗联合抗病毒治疗疗效、不良反应情况.方法:87例恶性肿瘤合并HBV感染者,根据其初始HBV DNA拷贝数随机分为两组,即初始HBV定量≥1×103GE/m L的患者44例,43例患者初始拷贝数<1×103GE/m L;常规化疗前1 wk给予抗病毒治疗,化疗结束后维持3 mo的抗病毒治疗.结果:初始HBV DNA拷贝数<1×103GE/m L组患者的Karnofsky功能状态(Karnofsky performance status,KPS)评分明显优于≥1×103G E/m L组患者;同时,两组患者在近期疗效方面比较相似,而远期疗效的比较发现,低拷贝组患者其6 mo以后的疾病进展和死亡风险相对更低,而化疗期间联合抗病毒并没有增加相关的不良反应.结论:对于恶性肿瘤合并HBV感染的患者,化疗期间联合抗病毒至关重要,这对于改善患者KPS、不良反应及远期疗效具有深远意义.AIM： To understand the impact of different ini- tial hepatitis B virus （HBV） DNA copies on the efficacy and side effects of chemotherapy com- bined with antiviral therapy in tumor patients with hepatitis B. METHODS： Eighty-seven tumor patients with HBV infection were randomly divided into two groups according to the initial HBV DNA cop- ies： A and B. Group A included 44 patients with the initial HBV DNA copies 〉/ 1 x 103 GE/mL, while group B included 43 patients with the ini- tial HBV DNA copies 〈 1×103 GE/mL. All of the patients had been treated with antiviral therapy for one month before conventional chemothera- py and continued to receive antiviral therapy forthree months after chemotherapy RESULTS： The Karnofsky performance status （KPS） score was significantly higher in group B than in group A. The short-term therapeutic effects were similar between groups A and B, while in terms of long-term efficacy, the disease progression and death risk at 6 mo after chemo- therapy were significantly lower in group B than in group A. The rate of related side effects did not increase significantly during chemotherapy combined with antiviral therapy. CONCLUSION： For tumor patients with HBV infection, chemotherapy combined with antivi- ral therapy is superior to chemotherapy alone in terms of improving the KPS score and side ef- fects.

关 键 词：对于恶性肿瘤合并HBV感染的患者 化疗期间联合抗病毒至关重要 这对于改善患者KPS 不良反应及远期疗效具有深远意义 

分 类 号：R512.62[医药卫生—内科学]