HBV感染与弥漫性大B细胞淋巴瘤患者临床特征及化疗后肝功能的关系  

Relationship between HBV infection and clinical characteristics of diffuse large B-cell lymphoma patients,and liver function after chemotherapy

作　　者：刘冰[1] 王舒[1] 陈宛丽[1] 杨莹[1] 姬玉涵 LIU Bing;WANG Shu;CHEN Wan-li;YANG Ying;JI Yu-han(Nanyang Second General Hospital,Nanyang,Henan 473000,China)

机构地区：[1]南阳市第二人民医院血液淋巴瘤科,河南南阳473000

出　　处：《中华医院感染学杂志》2022年第17期2574-2578,共5页Chinese Journal of Nosocomiology

基　　金：河南省卫生科技计划基金资助项目(2018108)。

摘　　要：目的探讨乙型肝炎病毒(HBV)感染与弥漫性大B细胞淋巴瘤(DLBCL)患者临床特征及化疗后肝功能的关系。方法选取2017年10月-2020年12月南阳市第二人民医院收治的HBsAg阳性DLBCL患者47例纳入HBsAg阳性组,HBsAg阴性DLBCL患者70例纳入HBsAg阴性组,比较两组患者临床分期、脾脏受累、淋巴结外器官受累、国际预后指数评分(IPI),分析HBsAg阳性组患者化疗前HBV-DNA病毒载量及化疗后病毒再激活与肝功能损伤的关系。结果HBsAg阳性组与HBsAg阴性组性别、年龄、淋巴结外器官受累数量、IPI评分比较差异无统计学意义,HBsAg阳性组临床分期Ⅲ~Ⅳ期、脾脏受累比例高于HBsAg阴性组(P<0.05);HBsAg阳性组化疗后肝功能损伤发生率为(48.94%)高于HBsAg阴性组(22.86%)(P<0.05);HBsAg阳性组不同HBV-DNA载量患者肝功能损伤发生率比较差异有统计学意义(P<0.05),HBV-DNA>10^(7)拷贝/ml患者肝功能损伤发生率为77.78%(7/9),<10^(3)拷贝/ml患者肝功能损伤发生率为18.18%(2/11);HBsAg阳性组化疗后HBV再激活患者肝功能损伤发生率高于未激活患者(P<0.05)。结论HBsAg阳性DLBCL患者相较于HBsAg阴性患者临床分期高,脾脏受累风险更高,患者化疗后肝脏损伤程度与HBV病毒载量相关,HBV再激活患者预后相对较差。OBJECTIVE To explore the relationship between hepatitis B virus(HBV)infection and clinical characteristics of patients with diffuse large B-cell lymphoma(DLBCL),and liver function after chemotherapy.METHODS Totally 47 HBsAg-positive DLBCL patients who were treated in Nanyang Second People′s Hospital from Oct 2017 to Dec 2020 were assigned as the HBsAg-positive group,and 70 HBsAg-negative DLBCL patients were chosen as the HBsAg-negative group.The clinical stage,involvement of spleen,involvement of extranodal organs and international prognostic index(IPI)were observed and compared between the two groups of patients,and the relationship between HBV-DNA load before chemotherapy,viral rectivation after chemotherapy and damage of liver function of the HBsAg-positive patients was analyzed.RESULTS There were no significant differences in the gender,age,number of extranodal organs involved and IPI score between the HBsAg-positive group and the HBsAg-negative group.The proportions of patients with clinical stageⅢandⅣand involvement of spleen were significantly higher in the HBsAg-positive group than in the HBsAg-negative group(P<0.05).The incidence of liver function damage of the HBsAg-positive group was 48.94%after chemotherapy,significantly higher than 22.86%of the HBsAg-negative group(P<0.05).In the HBsAg-positive group,there was significant difference in the incidence of liver function damage among the patients with different HBV-DNA loads(P<0.05);the incidence of liver function damage of the patients with HBV-DNA load more than 107 copies/ml was 77.78%(7/9),the patients with HBV-DNA load less than 10^(3)copies/ml 18.18%(2/11).In the HBsAg-positive group,the incidence of liver function damage of the patients with rectivation of HBV was significantly higher than that of the patient without activation(P<0.05).CONCLUSION As compared with the HBsAg-negative DLBCL patients,the HBsAg-positive DLBCL patients have higher clinical stage and are at higher risk of involvement of spleen.The severity of liver damage is associ

关 键 词：弥漫性大B细胞淋巴瘤 乙型肝炎病毒 病理特征 化疗 肝功能 关系 

分 类 号：R733.4[医药卫生—肿瘤]