摘要
目的探讨预防性抗病毒治疗对接受肝动脉化疗栓塞术(TACE)的乙型肝炎病毒(HBV)DNA阴性乙肝相关性肝细胞癌的效果。方法 HBV DNA阴性乙肝相关性肝癌并接受TACE治疗的患者54例,其中TACE治疗前1周开始应用抗病毒药物的30例为治疗组,TACE前未抗病毒治疗,TACE术后病毒转阳才抗病毒者24例为对照组。观察2组TACE术后HBV DNA转阳数、HBV DNA转阳时距离最后一次TACE的时间、异常ALT数、ALT和AST峰值、病毒再活化所致肝衰竭数等。结果治疗组HBV DNA转阳数、异常ALT数、病毒再活化导致ALT异常数、ALT峰值及AST峰值均少于对照组(P<0.05)。治疗组无一例患者发生病毒转阳所致的肝衰竭,对照组有4例发生病毒转阳所致肝衰竭。2组累积生存率差异无统计学意义(P=0.071)。结论对接受TACE治疗的HBV DNA阴性乙肝相关性肝细胞癌患者,预防性抗病毒治疗可以抑制病毒复制,维持肝功能稳定,降低病毒转阳所致的肝衰竭发生率。
Objective To investigate the effects of prophylactic antiviral therapy for HBV DNA negative HBV-related hepatocellular carcinoma （HCC） patients undergoing hepatic arterial chemoembolization （TACE）. Methods Fifty-four consecutive patients with HBV-related HCC and received TACE were enrolled in this study. Thirty patients received pre- emptive antiviral drugs before TACE were defined as the treatment group. Twenty-four patients, who did not use antiviral drugs until HBV reactivation after TACE, were included in control group. The incidence of HBV reactivation, duration from HBV DNA positive point to the last time of TACE, the occurrence of abnormal alanine aminotransferase （ALT） caused by HBV reactivation, the peak of aspartate aminotransferase （AST） and the number of liver failure caused by HBV reactivation were observed after TACE in two groups. Results The incidence of HBV reactivation, the occurrence of abnormal ALT, the occurrence of abnormal ALT caused by HBV reactivation, the peak ALT and peak AST were significantly lower in treatment group than those of control group （P 〈 0.05）. No liver failure caused by HBV reactivation was found in treatment group. There were four patients with liver failure caused by HBV reactivation in control group. There was no significant difference in cumulative survival rate between two groups （P=0.071）. Conclusion It is suggested that preemptive antiviral therapy can prevent the reactivation of hepatitis B virus, prevent the deterioration of liver function, and decrease the occurrence of liver failure caused by HBV reactivation in patients receiving TACE.
出处
《天津医药》
CAS
北大核心
2013年第9期875-877,共3页
Tianjin Medical Journal
关键词
肝炎
乙型
慢性
抗病毒药
癌
肝细胞
肝动脉
抗肿瘤联合化疗方案
存活率
临床对照试验
hepatitis B, chronic
antiviral agents
carcinoma, hepatocellular
hepatic artery
antineoplasticcomined chemotherapy protocols
survival rate
controlled clinical trial
