【摘要】 目的:探讨恩替卡韦联合化疗对乙肝病毒阳性但肝功能正常肿瘤患者的影响。方法:选取乙肝病毒阳性但肝功能正常的肿瘤患者106例,按治疗方案分为观察组(44例)和对照组(62例)。对照组患者根据肿瘤情况进行对应的常规化疗;观察组患者在化疗前1周口服恩替卡韦片0.5 mg,qd,连续使用1周。比较两组患者的乙肝病毒再激活率、重型肝炎复发率、病死率、治疗前后血清丙氨酸转氨酶(ALT)水平及不良反应发生率。结果:观察组患者脱落4例,对照组患者脱落2例。观察组患者的乙肝病毒再激活率、重型肝炎复发率以及病死率分别为7.5%、0、0,对照组分别为56.7%、50.0%、13.3%,组间比较差异均有统计学意义(P<0.05)。化疗前,两组患者血清ALT水平比较,差异无统计学意义(P>0.05);化疗后,两组患者血清ALT水平均显著升高,且对照组明显高于观察组,差异均有统计学意义(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论:恩替卡韦能有效预防肿瘤患者化疗时乙肝病毒的再激活,并降低重型肝炎复发率和病死率,且不增加不良反应发生风险。更多还原

【Abstract】 OBJECTIVE:To explore the effects of entecavir combined with chemotherapy on positive HBV in tumor patients with normal liver function. METHODS:106 patients were selected and divided into observation group(44 cases) and control group(62 cases)according to therapy plan. Control group received routine chemotherapy according to tumor condition;observation group was given Entecavir tablets orally 0.5 mg,qd,before 1 week of chemotherapy,for consecutive 1 week. HBV reactivation rate,recurrence rate of severe hepatitis,mortality rate,serum level of ALT before and after treatment and the incidence of ADR were compared between 2 groups. RESULTS:4 patients of observation group and 2 of control group withdrew from the study. HBV reactivation rate,recurrence rate of severe hepatitis and mortality were 7.5%,0,0 in observation group and 56.7%,50.0%,13.3% in control group,with statistical significance between 2 groups(P<0.05). Before chemotherapy,there was no statistical significance in serum levels of ALT between 2 groups(P>0.05);after chemotherapy,the serum levels of ALT in 2 groups were increased significantly,and the control group was significantly higher than the observation group,with statistical significance(P<0.05). There was no statistical significance in the incidence of ADR between 2 groups(P>0.05). CONCLUSIONS:Entecavir can effectively prevent HBV reactivation and decrease the recurrence rate of severe hepatitis and mortality rate in tumor patients during chemotherapy, and doesn’t increase the risk of ADR.更多还原