乳腺癌患者化疗时乙肝病毒的再激活及核苷类抗病毒药物的预防效果分析  

REACTIVATION OF HEPATITIS B VIRUS AND THE PREVENTIVE EFFECT OF ANTIVIRAL THERAPY FOR BREAST CANCER PATIENTS RECEIVING CHEMOTHERAPY WITH POSITIVE HBSAG

作　　者：李修明[1] 姜英俊[2] 孔心涓[2] 武军[2] 荆雪[2] 田字彬[2] 

机构地区：[1]青岛大学,山东青岛266071 [2]青岛大学医学院附属医院

出　　处：《山东医学高等专科学校学报》2016年第3期185-188,共4页Journal of Shandong Medical College

摘　　要：目的探讨HBsAg阳性的乳腺癌患者化疗后HBV的再激活及抗病毒药物的预防作用。方法收集临床资料完整的乳腺癌化疗患者766例,其中筛查出HBsAg阳性且化疗前肝功能正常的患者86例,其中56例仅单独给予化疗(对照组),30例化疗前2周给予抗病毒治疗(治疗组)。比较两组化疗开始后1周、1月的HBV再激活及肝功能损伤情况。结果 86例HBsAg阳性患者中12例出现HBV再激活,治疗组和对照组分别为1例和11例(3.33%vs19.64%,P=0.003)。两组共有16例(18.6%)出现肝炎复发,治疗组和对照组分别为2例和14例(6.66%vs 25%,P=0.001);轻度肝炎在治疗组和对照组分别为1例和9例(3.33%vs 16.07%,P=0.004),中、重度肝炎(1vs 4,0vs 1)两组比较无统计学意义(P>0.05)。治疗组无化疗延迟,对照组有9例出现化疗延迟(0vs 16.07%,P=0.006)。结论乳腺癌患者化疗前均应进行HBV感染筛查,HBsAg阳性的患者预防性的抗病毒治疗能显著降低化疗时HBV的再激活率。Objective To study the reactivation of hepatitis B virus and the preventive effect of antiviral therapy for breast cancer patients receiving chemotherapy with positive HBsAg.Methods The complete clinical data of 766 breast cancer patients undergoing chemotherapy were reviewed.Of the 86 HBsAg positive patients with normal liver functions before chemotherapy,30 patients formed the treatment group receiving antiviral treatment and 56 patients formed the control group receiving only chemotherapy.Liver function injury and HBV reactivation rate were tested one week and one month later respectively.Results 12 of the 86 cases with positive HBsAg had HBV reactivation,one case（3.33%）in the treatment group and 11（19.64%）in the control group（P =0.003）.16cases（18.6%）developed hepatitis.Of the 16 patients,2cases（6.66%）were in the treatment group and 14cases（25%）in the control group（P =0.001）.Slight hepatitis occurred in one case（3.33%）in the treatment group and 9cases（16.07%）in the control group（P =0.004）.There is no statistical significance between the two groups in terms of moderate and severe hepatitis（P 〉0.05）.Chemotherapy delay occurred in 9cases in the control group,while no chemotherapy delay occurred in the treatment group（P =0.006）.ConclusionIt is necessary for breast cancer patients to receive HBV infection screening before chemotherapy,and prophylactic antiviral therapy can significantly reduce the incidence of HBV reactivation in breast cancer patients undergoing chemotherapy.

关 键 词：乳腺癌 化疗 激活 抗病毒治疗 

分 类 号：R512.6[医药卫生—内科学]