拉米呋定预防化疗中乙型肝炎活动的临床分析

目的:分析研究合并乙型肝炎病毒(HBV)感染的肿瘤患者预防应用拉米呋定是否减少化疗中乙型肝炎病毒再活化。方法:回顾性分析本科2000年2月～2005年8月收治的39例合并HBV感染的需化疗的乳腺癌、非小细胞肺癌、非霍杰金淋巴瘤(NHL)和骨肉瘤患者的治疗方法,按是否从化疗前1周开始口服拉米呋定分为:治疗组18例,对照组21例。前者口服拉米呋定,至化疗后6个月。比较化疗后肝功能损害、急性肝炎、HBV再活化和化疗延迟等指标的变化。结果:两组比较,治疗组肝功能损害发生率无显著性差异(55.6%vs.42.9%,P=0.429),急性肝炎发生率明显下降(11.1%vs.57.1%,P=0.006),HBV再活化发生率下降(5.6%vs.38.1%,P=0.023),而化疗延迟发生率下降(16.7%vs.61.9%,P=0.008)。结论:预防性口服拉米呋定可能可以有效抑制HBV复制和肝炎活动,值得进一步研究。

Preemptive use of lamivudine for HBV infection cancer patients undergoing cytotoxic chemotherapy

Objective:To assess the less of HBV reactivation that preemptive use of lamivudine for cancer patients with chronic hepatitis B virus receiving cytotoxic chemotherapy.Methods:From Feb 2000 to Aug 2005,there were 39 patients with Breast cancer,NSCLC,NHL or Osteosarcoma were divided treatment group(18 patients)and control group(21 patients)according to using lamivudine in our retrospective study.In treatment group,100mg daily lamivudine was administered I week before chemotherapy until 6 months after completion of chemotherapy.Function damage of liver,incidence of sever hepatitis,HBV reactivation and disruption of chemotherapy were used for observation the effect.Results:Comparing to the two groups results,the incidence rate of Function damage of liver was no significantly less(55.6% vs.42.9%,P=0.429)in treatment group.But there were significantly less at incidence rate of the sever hepatitis(11.1% vs.57.1%,P=0.006),the sever hepatitisless HBV reactivation(5.6% vs.38.1%,P=0.023)and the disruption of chemotherapy(16.7% vs.61.9%,P=0.008)in treatment group,respectively.Conclusion:Preemptive use of lamivudine maybe reduce the incidence of HBV reactivation for HBV Infection cancer patients undergoing cytotoxic chemotherapy.