合并实体瘤的非活动性HBsAg携带者围化疗期抗病毒治疗的临床分析  

Clinical Analysis of Antiviral Therapy in Inactive HBsAg Carriers with Solid Tumors in the Peri-chemotherapy Period

作　　者：关瀛 李莉 胡立立 罗雪艳 GUAN Ying;LI Li;HU Li-li(Department of Infectious Diseases,Qianxinan People’s Hospital,Xingyi,Guizhou,562400,China)

机构地区：[1]黔西南州人民医院感染科,贵州兴义562400 [2]黔西南州人民医院全科,贵州兴义562400 [3]黔西南州人民医院肿瘤科,贵州兴义562400

出　　处：《黑龙江医学》2023年第11期1285-1288,共4页Heilongjiang Medical Journal

摘　　要：目的:回顾性分析合并实体瘤的非活动性HBsAg携带者围化疗期抗病毒治疗的临床效果。方法:选取2013年4月—2020年12月黔西南州人民医院收治的80例实体瘤且接受化疗的非活动性HBsAg携带者作为研究对象,随机分为治疗组32例和对照组48例。治疗组在化疗前给予恩替卡韦(ETV)进行预防性抗病毒治疗,对照组在化疗前不给予抗病毒治疗,仅当其转氨酶持续上升或HBV DNA转阳时,加以ETV进行抗病毒治疗。结果:治疗组中发生HBV再激活2例(6.25%),出现肝损伤4例(12.5%),化疗结束时HBV DNA未转阴2例,肝功能恢复正常3例,另外肝功能仍有异常1例。对照组中出现HBV再激活6例(12.5%),化疗结束时HBV DNA转阴4例,HBV DNA未转阴2例,出现肝损伤8例(16.67%),化疗结束时肝功恢复正常3例,肝功未恢复至正常5例,两组患者再激活和肝损伤发生率比较,差异无统计学意义(P>0.05)。化疗结束时,两组患者肝功能及HBV DNA的变化情况比较,差异无统计学意义(P>0.05)。出现HBV再激活和肝损伤的患者均未出现肝衰竭和延迟化疗等情况。结论:对于合并实体瘤的非活动性HBsAg携带者,在化疗后检测到HBV DNA再激活或转氨酶(ALT)大于正常值的2倍时,加以抗病毒药物,既可达到理想疗效,又可节省治疗费用。Objective:To retrospectively analyze the clinical outcomes of peri-chemotherapy antiviral therapy in inactive HBsAg carriers with comorbid solid tumors.Methods:80 inactive HBsAg carriers with solid tumors admitted to the hospital and receiving chemotherapy from April 2013 to December 2020 were screened as study subjects and were randomly divided into 32 cases in the treatment group and 48 cases in the control group.The treatment group was given prophylactic antiviral therapy with entecavir(ETV)before chemotherapy,while the control group was given no antiviral therapy before chemotherapy,and ETV was added only when their transaminases continued to rise or their HBV DNA turned positive.Results:In the treatment group,HBV reactivation occurred in 2 cases(6.25%),liver injury occurred in 4 cases(12.5%),HBV DNA did not turn negative in 2 cases at the end of che⁃motherapy,liver function returned to normal in 3 cases,and liver function was still abnormal in 1 case.In the control group,there were 6 cases(12.5%)of HBV reactivation,4 cases of HBV DNA conversion at the end of chemotherapy,2 cases of HBV DNA non-conversion,8 cases(16.67%)of liver injury,3 cases of liver function returning to normal at the end of chemotherapy,and 5 cases of liver function not returning to normal.The difference in the incidence of reactivation and liver injury between the two groups was not statistically significant(P>0.05).At the end of chemotherapy,there was no statistically significant difference in the changes of liver function and HBV DNA between the two groups(P>0.05).None of the patients who developed HBV reactivation and liver injury experienced liver failure or delayed chemotherapy.Conclusion:For inactive HBsAg carriers with combined solid tumors,when HBV DNA reactivation or transaminases(ALT)greater than twice the normal value is detected after chemotherapy,antiviral drugs should be administered to achieve the desired efficacy and save the cost of treatment.

关 键 词：乙肝病毒 再激活 肿瘤 化疗 

分 类 号：R73[医药卫生—肿瘤]