HBsAg阳性恶性肿瘤患者化疗后肝损伤及HBV再激活的临床分析
目的探讨HBsAg阳性肿瘤患者化疗后肝损伤情况及HBV再激活的相关危险因素。方法收集2011年1月-2013年12月在汕头市中心医院接受化疗的HBsAg阳性的恶性肿瘤患者共150例。其中43例行预防性抗病毒治疗,即化疗前、化疗期间和化疗结束后半年使用抗病毒治疗(试验组),107例未行预防性抗病毒治疗(对照组)。回顾性分析2组患者化疗后肝损伤情况。计数资料组间比较采用χ2检验,使用Logistic回归分析法分析影响化疗后HBV再激活的相关因素。结果所有患者经过化疗,63例(42.0%)出现肝损伤,其中肝脏不良反应分级:Ⅰ度13例(8.7%)、Ⅱ度29例(19.3%)、Ⅲ度15例(10.0%)、Ⅳ...
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Published in | 临床肝胆病杂志 Vol. 32; no. 1; pp. 110 - 113 |
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Main Author | |
Format | Journal Article |
Language | Chinese |
Published |
汕头市中心医院 肿瘤放疗科,广东 汕头,515031
2016
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Subjects | |
Online Access | Get full text |
ISSN | 1001-5256 |
DOI | 10.3969/j.issn.1001-5256.2016.01.020 |
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Summary: | 目的探讨HBsAg阳性肿瘤患者化疗后肝损伤情况及HBV再激活的相关危险因素。方法收集2011年1月-2013年12月在汕头市中心医院接受化疗的HBsAg阳性的恶性肿瘤患者共150例。其中43例行预防性抗病毒治疗,即化疗前、化疗期间和化疗结束后半年使用抗病毒治疗(试验组),107例未行预防性抗病毒治疗(对照组)。回顾性分析2组患者化疗后肝损伤情况。计数资料组间比较采用χ2检验,使用Logistic回归分析法分析影响化疗后HBV再激活的相关因素。结果所有患者经过化疗,63例(42.0%)出现肝损伤,其中肝脏不良反应分级:Ⅰ度13例(8.7%)、Ⅱ度29例(19.3%)、Ⅲ度15例(10.0%)、Ⅳ度6例(4.0%),2组肝损伤程度差异具有统计学意义(χ2=19.498,P=0.001)。试验组肝损伤发生率为18.6%(8例),比对照组51.4%(55例)明显降低,差异有统计学意义(χ2=25.864,P〈0.001)。Logistic单因素回归分析显示,化疗前乙型肝炎六项状态、HBV定量、是否使用激素及是否预防性使用抗病毒治疗差异具有统计学意义,将其纳入Logistic多因素回归分析显示,这4项指标均是患者化疗后HBV再激活的独立影响因素,其中预防性抗病毒治疗是患者化疗后HBV再激活唯一保护性因素。结论 HBsAg阳性肿瘤患者化疗后肝损伤发生率较高,预防性使用抗病毒治疗可以有效降低HBV再激活的发生率,从而减少肝损伤的发生。 |
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Bibliography: | WU Shengxi, XU Hongyao, HUANG Hecheng, et al. ( Department of Radation Oncology, Shantou Central Hospital, Shantou, Guangzhou 515031, China) neoplasms; antineoplastic combined chemotherapy protocols; hepatitis B surface antigens; hepatitis B virus; virus activation Objective To investigate the occurrence of liver injury and related risk factors for hepatitis B virus (HBV) reactivation after chemotherapy in HBsAg - positive patients with malignant tumors. Methods A total of 150 HBsAg - positive patients with malignant tumors who received chemotherapy in Shantou Central Hospital from January 2011 to December 2013 were collected ; 43 patients received prophylac- tic antiviral therapy, i. e. , the application of antiviral therapy before, during, and within half a year after chemotherapy (experiment group) , and 107 patients did not receive prophylactic antiviral therapy (control group). The occurrence of liver injury after chemotherapy in both groups was analyzed retrospectively. Chi - square test was applied for c |
ISSN: | 1001-5256 |
DOI: | 10.3969/j.issn.1001-5256.2016.01.020 |