【摘要】 目的观察拉米呋啶对携带乙肝病毒(HBV)癌症患者化疗导致病毒重激活的预防以及对患者肝功能的影响。方法收集2003年1月至2008年1月在本院进行化疗的携带HBV癌症患者89例,随机分为化疗组(n=45)和拉米呋啶组(n=44),检测两组化疗前后谷草转氨酶(AST)、谷丙转氨酶(ALT)、总胆红素、白蛋白(ALB)、血清淀粉酶、HBV标记物和HBV DNA水平,同时进行肿瘤化疗及疗效的常规指标检测。结果治疗前两组的AST、ALT、总胆红素、ALB和HBV DNA水平比较差异均无统计学意义;治疗后拉米呋啶组4.5%的患者出现肝功能异常,而化疗组为86.7%,同时化疗组的AST、ALT和HBV DNA水平明显增高,而总胆红素和ALB无明显变化;毒副反应发生率两组比较差异无统计学意义。结论拉米呋啶可预防HBV感染的癌症患者化疗后病毒的重新激活,且毒副作用较小。更多还原

【Abstract】 Objective HBV reactivation is common in hepatitis patients who receive tumor chemotherapy.The objective is to evaluate the use of lamivudine as the primary prophylaxis for HBV reactivation in patients undergoing tumor chemotherapy.Methods Eighty nine HBV type hepatitis patients with cancer in Zhuhai City Hospital received tumor chemotherapy according to the standard international guidelines from January,2003 to January,2008.Of 89 cases,44 patients received chemotherapy plus lamivudine(groupⅠ),the left 45 patients received chemotherapy alone(group Ⅱ).The liver function indexes including AST,ALT,total bilirubin,ALB,HBV DNA were checked before and after the treatments.The short term curative effect for chemotherapy was evaluated.Results Before the treatment,no significant difference was observed in the liver function indexes between the two groups.After the treatment,4.5% group I patients and 86.7% group II patients had abnormal liver function indexes(4.5% vs 86.7%,P=0.002);group I had lower level of AST,ALT and HBV DNA than that of group II(P<0.05);the total bilirubin and albumin level did not show significant difference between the two groups;the poisonous effect and side-effect were similar in the two groups.Conclusion Lamivudine may prevent HBV reactivation in HBV hepatitis patients undergoing tumor chemotherapy with less poisonous effect and side-effect.更多还原