拉米夫定预防肿瘤患者化疗后HBV激活的临床观察

目的：观察拉米夫定预防合并乙型肝炎病毒（HBV）感染的恶性肿瘤患者化疗后HBV激活的效果。方法：预防组30例合并HBV感染的恶性肿瘤患者在化疗前1周开始口服拉米夫定治疗，并持续用至化疗结束后6月；另外历史对照组40例患者未接受拉米夫定治疗，观察两组患者化疗前后血清HBVDNA、肝功能的动态变化。结果：化疗结束后的HBV激活率：对照组为52．5％，预防组仅为10％；化疗后肝炎的发生率：对照组为55％，预防组为16．7％，对照组22．5％延迟化疗、12．5％中断化疗，死亡率5％，预防组仅3．3％延迟化疗，无中断化疗或死亡患者；两组比较有显著差异。结论：预防性应用拉米夫能明显减少合并HBV感染的恶性肿瘤患者化疗后的HBV激活，进而减少化疗后肝炎的发生率和化疗延迟或中断率。

Preventive effect of Lamivudine to HBV reactivation of Tumor Patients with HBV Infection after Chemotherapy

Objective ：To observe Lamivudine＇s preventive effect to post - chemotherapy HBV reaction of tumor patients with HBV infection. Methods ：The prophylactic lamivudine group consisted of 30 patients who were treated：with oral lamivudine before one week and until six months after chemotherapy. The historical control group consisted of 40 patients who underwent chemotherapy without lamivudine treatment. Serum HBVDNA level and liver function of all patients were examined respectively before and after chemotherapy. Resuits ：The two groups appeared greatly different： the rate of HBV reaction after chemotherapy： historical group 52.5%, and prophylactic group only 10% ; the rate of hepatitis： historical group 55%, and prophylactic group 16.7% ; In the historical group, 22.5% of the patients had to postpone chemotherapy, 12.5% stopped chemotherapy, and the mortality was 5 % ;in prophylactic group, there were only 3.3% postponed chemotherapy, and none of them halt chemotherapy or die. Conclusion：prophylactic using lamivudine could obviously decrease HBV reaction of tumor patients with HBV infection after chemotherapy, furthermore reduce the rate of regenerating hepatitis, and halting or postponing chemotherapy.