大肠癌合并慢性乙型肝炎患者围手术期阿德福韦酯抗病毒治疗的临床研究

目的观察大肠癌并慢性乙肝围手术期乙肝病毒（HBV）活动情况及阿德福韦酯对其防治效果。方法对50例大肠癌并慢性乙型肝炎患者随机分组，观察组26例在围手术期每日1次给予阿德福韦酯口服，进行HBV DNA定量及肝功能检查；对照组24例在围手术期不进行抗病毒治疗，其他治疗检测同观察组。结果对照组HBV DNA定量，在术后1周、1月较术前增高值具有显著性意义（P〈0．05），研究组术后1周、1月HBV DNA定量较术前降低值亦有显著意义（P〈0．05）；两组术后ALT比较差异有显著性意义（P〈0．05）。术后1周、1月并发症发生率比较，差异无显著性意义（P〉0．05）。结论外科干预可激活HBV的复制能力，对病毒复制活跃的慢性乙肝患者须加强围手术期抗病毒治疗。阿德福韦酯有强大的抗HBV功能，可短期内迅速降低HBV载量并可促进围手术期肝功能恢复。

Investigation on perioperative Antivirus Treatment with adeforir on Chronic Hepatitis B Patients with Colon Cancer

Objective To study the activity of hepatitis B virus and therapeutic efficacy of adefovir in chron-ic hepatitis B patients with colon cancer during operation period. Methods 50 chronic hepatitis B patients with co-lon cancer to be underwent colon resection were divided two groups at random, one group was given adcfovir (adefovir group), the other group not (control group), and therapeutic measure except antivirus is the same. HBV-DNA con-centration and liver functon of the patients were detected. Results Serum HBV-DNA concentration and ALT level of the patients was increased significantly at 1 week and 1 month after operation compared with that before operation in control group. Serum HBV-DNA concentration of the patients was decreased significantly at 1 week and 1 month after operation compared with that before operation in adefovir group. The ALT level of patients in adefovir group is signifi-cantly lower than that in control group. Conclusions Surgical procedure may result in HBV replication and antivirus treatment should be done perioperatively. Adefovir can inhibite replication of HBV and also improve the liver function of the chronic hepatitis B patients with colon cancer during operation.