【摘要】 目的探讨HBs Ag(-)伴HBc Ab(+)妇科肿瘤患者行TP方案化疗后发生乙肝病毒再激活的肝功能损害情况。方法收集我院近7年收治的60例使用TP方案化疗的妇科肿瘤患者的临床资料,根据HBc Ab结果不同分为实验组及对照组,分析其肝脏损害程度及乙肝病毒再激活情况。结果实验组肝功能损害60.0%(18/30),对照组肝功能损害43.3%(13/30),两组差异无统计学意义(P>0.05);实验组肝功能损害Ⅰ度+Ⅱ度12例,Ⅲ度+Ⅳ度6例,对照组Ⅰ度+Ⅱ度12例,Ⅲ度+Ⅳ度1例,实验组肝功能损害程度更严重,两组差异有统计学意义(P<0.05)。实验组4例胆红素升高,对照组2例胆红素升高,两组差异无统计学意义(P>0.05);实验组乙肝再激活1×103Copies/m L<DNA≤1×105Copies/m L 5例,>1×105 Copies/m L 2例,对照组乙肝再激活0例,两组差异具有统计学意义(P<0.05)。实验组22例(73.3%)继续按期化疗,6例(20%)延期化疗,2例(6.7%)终止化疗;对照组30例按期化疗,两组差异有统计学意义(P<0.05)。结论 HBs Ag(-)伴HBc Ab(+)妇科肿瘤患者TP化疗严密观察肝功能,检测乙肝HBs DNA定量检测。更多还原

【Abstract】 Objective To discuss the liver function impairment by HBV reactivation after TP chemotherapy in patients with gynecologic tumors with HBs Ag(-) and HBc Ab(+).Methods Clinical materials of 60 patients with gynecologic tumors after TP chemotherapy were collected and divided based on HBc Ab results into study group and control group to analyze the liver function impairment and HBV reactivation.Results The rate of liver function impairment was 60.0%(18/30) in the study group and 43.3%(13/30) in the control group,which was not significantly different(P>0.05).There were 12 cases with Ⅰ and Ⅱ degree liver function impairment,and 6 cases with Ⅲ and Ⅳ degree in the study group;while in the control group,there were 12 cases with Ⅰ and Ⅱ degree and 1 case with Ⅲ and Ⅳ degree.The degree of liver function impairment was significantly severe in the study group than in the control group(P<0.05).Enhanced bilirubin was observed in 4 cases of study group and 2 cases of control group,which was not significantly different(P>0.05).As to HBV reactivation,5 cases were 1×10~3Copies/m L<DNA≤1×10~5Copies/m L,and 2 cases were >105;while there was 0 case of HBV reactivation in control group,which was significantly different between two groups(P<0.05).22 cases(73.3%) were given continuous regular chemotherapy,6 cases(20.0%) were given delayed chemotherapy,and 2 cases(6.7%) withdrew from chemotherapy;while 30 cases in control group were given regular chemotherapy,which was significantly different(P<0.05).Conclusion In patients with gynecologic tumors with HBs Ag(-) and HBc Ab(+),liver function should be closely monitored during TP chemotherapy and HBs DNA should be detected.更多还原