参麦注射液联合恩替卡韦在大肠癌伴乙肝病毒感染患者化疗中肝功能保护作用

目的:观察参注射液联合恩替卡韦在大肠癌伴乙肝病毒感染患者化疗中肝功能保护及抑制乙肝病毒复制作用。方法:68例感染乙肝病毒的大肠癌患者区组化随机分为治疗组(参麦+FOLFOX6方案化疗+恩替卡韦,34例)和对照组(FOLFOX6方案化疗+恩替卡韦,34例),化疗前及化疗后第3天、第4周末、第12周末检测肝功能,化疗前及化疗后第4周末、第12周末检测HBV DNA载量。结果:治疗后2组血清HBV DNA载量均增高(P<0.05)。在治疗第12周末,治疗组血清HBV DNA载量低于对照组。在治疗第3天、第4周末、第12周末,治疗组ALT/AST均低于同期对照组(P<0.05)。2组肝炎活动发生率比较差异有统计学意义(P<0.05)。结论:感染乙肝病毒的大肠癌患者化疗后可引起乙肝病毒再激活,并导致肝炎活动;参麦注射液能改善肝功能,对肝病毒再激活引起的肝损害有保护作用和一定的抗病毒作用,联合恩替卡韦抑制乙肝病毒作用更强,有更好的肝功能保护作用。

Effect of Shengmai Injection Combined with Entecavi on Protection of Liver Function and Antiviral Activity after Chemotherapy in Colorectal Cancer with HB Virus Infection

Objective:To observe effect of shengmai injection combined with entecavi on protection of liver function and antiviral activity after chemotherapy in colorectal cancer with HB virus infection.Methods 68 cases of colorectal cancer with hepatitis B virus infection were randomly divided into observer group(shengmai injection+FOLFOX6 chemotherapy + entecavir,34 cases) and control group(FOLFOX6 chemotherapy + entecavir,34 patients).Liver function was detected before and 3 days,4 weeks,12 weeks after chemotherapy.HBV DNA load was detected before and after 4 weeks.12 weeks after chemotherapy.Results:HBV DNA load increased in both of two groups after chemotherapy compared with the preoperative(P<0.05).The HBV DNA load in observer group lower than the HBV DNA load in control group at the first 12 weeks of treatment(P<0.05).At the treatment of the first 3 days and 4 weeks,12 weeks.the ALT/AST in observer group were lower than the ALT/AST in control group over the same period(P<0.05).The incidence of hepatitis was statistically significant difference between the two groups(P<0.05).Conclusion:Hepatitis B virus would reactive after chemotherapy in patients of colorectal cancer with hepatitis B virus infection,which would cause hepatitis activities.There was a stronger inhibitory effect of shengmai injection combined with entecavi to HBV replication after chemotherapy compared entecavir alone,and the treatment of shengmai injection combined with entecavi has a protective effect to liver function.