摘要
目的乙型肝炎病毒(hepatitis B virus,HBV)感染者在接受细胞毒性化疗或免疫抑制治疗时存在HBV再激活的风险。文中探讨HBV感染的消化道恶性肿瘤术后化疗患者化疗后HBV再激活及肝功能损害发生情况。方法回顾性分析102例合并HBV感染的胃癌和结、直肠癌术后患者HBV再激活情况,所有患者进行HBV血清学和生物化学检测。结果 102例患者有46.1%(47/102)出现肝功能异常,有40.2%(41/102)出现HBV再激活;41例HBV再激活患者中35例出现肝功能异常(85.4%),其中16例化疗剂量调整或推迟化疗,8例终止化疗。HBV再激活肝功能异常发生率(85.4%)高于未出现HBV再激活患者(19.7%,12/61),两者比较差异有统计学意义(P<0.01);化疗前检测HBV-DNA>103拷贝/ml患者HBV再激活发生率高于HBV-DNA<103拷贝/ml患者(60.0%vs 27.4%,P<0.01)。结论 HBV感染的消化道肿瘤术后患者接受化疗时存在HBV再激活并导致肝功能损害,化疗前HBV-DNA高者更易发生HBV再激活。
Objective Patients with hepatitis B virus （HBV） infection undergoing cytotoxic chemotherapy or immunologic suppression therapy face the risk of HBV reactivation. This study was to investigate HBV reactivation and liver damage in HBV-infected patients with digestive tract malignancy after postoperative chemotherapy. Methods We retrospectively analyzed 102 HBV-infected patients with gastric or colon and rectal cancer that received chemotherapy after surgery. We conducted serological and biochemical tests of HBV for all the patients. Results Among the 102 cases, abnormal liver function （ALF） was found in 47 （46.1% ） and HBV reactivation in 41 （40.2%）, of the latter 41 cases, 35 （85.4%） with ALF, including 16 cases that necessitated adjustment or delay of chemotherapy, and another 8 termination of chemotherapy because of severe liver damage. The rate of ALF was significantly higher in the patients with HBV reactivation than in those without （85.4% vs 19.7%, P 〈 0.01 ）, and so was the incidence of HBV reactivation in the patients with HBV-DNA 〉 103 copies/ml than in those with HBV-DNA 〈 103 copies/ml before chemotherapy （60.0% vs 27.4%, P 〈 O. O1 ）. Conclusion HBV reactivation occurs in HBV-infected patients with digestive tract malignancy re- ceiving postoperative chemotherapy, which may lead to liver damage, and it is more likely to occur in those with a higher level of HBV- DNA before chemotherapy.
出处
《医学研究生学报》
CAS
北大核心
2013年第11期1186-1188,共3页
Journal of Medical Postgraduates
关键词
消化道肿瘤
化疗
肝炎
乙型肝炎病毒
Digestive tract malignancy
Chemotherapy
Hepatitis
Hepatitis B virus
