| 摘要: |
| 目的探讨恶性肿瘤合并HBV感染患者化疗后HBV再激活及相关高危因素。方法选择经病理学检查确诊为恶性肿瘤且需化疗的患者78例，其中HBsAg阳性者（观察组）34例，HBsAg阴性者（对照组）44例。观察两组患者在化疗过程中HBV再激活的情况，对两组患者在治疗前与治疗后的肝功能指标进行比较，分析HBV再激活的影响因素。结果观察组患者出现HBV再激活9例（26.47%），化疗后肝功能损害发生率52.94%（18/34），高于对照组29.55%（13/44），差异有统计学意义（P＜0.05）。糖皮质激素、蒽环类药物为HBV再激活的独立危险因素（均P＜0.05或0.01）。结论恶性肿瘤合并HBV感染患者接受化疗时肝功能损害较HBV阴性者严重，存在HBV再激活的风险，激素与蒽环类的应用是HBV再激活的高危因素。 |
| 关键词: 恶性肿瘤 化疗 再激活 |
| DOI：10.12056/j.issn.1006-2785.2017.39.14.2017-51 |
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| Risk factors of HBV reactivation in HBV-infected patients with malignant tumor undergoing chemotherapy |
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ZHOU Jianwei, LIN Jiejun, ZHANG Hui, ZHU Fangchao, HUANG Zhiming
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the Dingli Clinical School of Wenzhou Medical University
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| Abstract: |
| Objective To investigate the risk factors of HBV reactivation in HBV-infected patients with malignant neoplasms undergoing chemotherapy. Methods Seventy eight patients with malignant tumors undergoing chemotherapy, including 34 patients with positive HBsAg (study group) and 44 patients with negative HBsAg (control group), were enrolled in the study. The reactivation of HBV during chemotherapy was observed; the liver function indicators were measured before and after treatment and compared between two groups. The risk factors related to HBV reactivation were analyzed. Results HBV reactivation occurred in9 cases (26.47%) of study group. The incidence of liver injury after chemotherapy was 52.94% (18/34),
which was higher than that of control group(29.55%, 13/44), the difference was statistically significant(P＜0.05). The administration
of glucocorticoids and anthracycline drugs was a risk factor of HBV re-activation in HbsAg-positive patients. Conclusion Liver damage during chemotherapy is more serious in cancer patients with HBV infection, and the use of steroids and anthracycli- nesincreased the risk of HBV reactivation in those patients. |
| Key words: Malignant neoplasms Chemotherapy Reactivate |
