恩替卡韦预防鼻咽癌治疗中乙肝病毒再激活的临床研究  

Clinical Study on Preventive Effects of Entecavir against HBV Reactivation of Nasopharyngeal Carcinoma Therapy

作　　者：李思维[1] 白雪[1] 何卓凯[1] 赵博[1] 柳正春[1] 刘光华[2] 

机构地区：[1]桂林医学院附属医院放疗科,广西桂林541004 [2]桂林医学院第二附属医院耳鼻咽喉头颈外科,广西桂林541199

出　　处：《中国药房》2016年第11期1507-1510,共4页China Pharmacy

基　　金：国家自然科学基金资助项目(No.81460430);广西医疗卫生适宜技术研究与开发项目(No.S201407-05)

摘　　要：目的:探讨恩替卡韦对鼻咽癌治疗中乙肝病毒(HBV)再激活的预防作用。方法:选择2010年5月-2012年7月于桂林医学院附属医院住院的乙肝病毒脱氧核糖核酸(HBV-DNA)阳性鼻咽癌患者87例作为研究组,2005年5月-2007年1月于该院住院的HBV-DNA阳性鼻咽癌患者79例作为对照组。对照组患者采用常规放化综合治疗方式,研究组患者在放疗或化疗前1周开始服用恩替卡韦分散片,每日0.5 mg,根据患者具体病情完成疗程。观察并比较两组患者临床转归情况、治疗前后血清HBV-DNA与丙氨酸转氨酶(ALT)水平变化、肝功能Child-Pugh分级情况。结果:研究组患者因HBV再激活导致的治疗中断率为3.45%,对照组为11.39%,组间比较差异有统计学意义(P<0.05)。治疗后4周,研究组患者的HBV-DNA定量结果与ALT水平均较治疗前及对照组显著下降,差异有统计学意义(P<0.05)。两组患者治疗前后的肝功能Child-Pugh分级比较,差异均无统计学意义(P>0.05)。结论:恩替卡韦预防性用药能够显著降低鼻咽癌治疗中HBV再激活率。OBJECTIVE：To investigate the preventive effect of entecavir against HBV reactivation of nasopharyngeal carcinoma therapy. METHODS：87 inpatients with HBV-DNA positive nasopharyngeal carcinoma were selected from the Affiliated Hospital of Guilin Medical College during May 2010-Jul. 2012 as research group,and 79 inpatients with HBV-DNA positive nasopharyngeal carcinoma were selected from the hospital during May 2005-Jan. 2007 as control group. Control group was treated by routine radiotherapy and chemotherapy. Research group was given Entecavir dispersible tablet one week before radiotherapy or chemotherapy,0.5 mg each day,and completed treatment course according to disease condition. Clinical outcome,the levels of serum HBV-DNA and ALT and liver function Child-Pugh grades before and after treatment were observed and compared between 2groups. RESULTS：3.45% of patients suspended treatment in research group due to HBV reactivation and 11.39% in control group,with statistical significance（P〈0.05）. After 4 weeks of treatment,HBV-DNA PCR and ALT level of research group decreased significantly compared to before treatment and control group,with statistical significance（P〈0.05）. There were no statistical significance in liver function Child-Pugh grades between 2 groups before and after treatment（P〉0.05）. CONCLUSIONS：Prophylactic application of entecavir can significantly reduce the rate of HBV reactivation in nasopharyngeal carcinoma therapy.

关 键 词：恩替卡韦 鼻咽癌 乙肝病毒再激活 乙肝病毒脱氧核糖核酸 

分 类 号：R969.4[医药卫生—药理学]