恩替卡韦预防B细胞淋巴瘤患者R―CHOP方案化疗后HBV激活的临床研究.docVIP

恩替卡韦预防B细胞淋巴瘤患者R―CHOP方案化疗后HBV激活的临床研究 　　[摘要] 目的 探讨恩替卡韦预防B细胞淋巴瘤患者R-CHOP方案化疗后HBV激活的临床效果。 方法 回顾性调查在本院接受R-CHOP方案化疗的B细胞淋巴瘤患者的临床资料，根据应用恩替卡韦时机的不同，分为预防组和治疗组，对比和分析两组的临床特征及HBV激活情况。 结果 共51例患者符合纳入标准，预防组25例，治疗组26例，预防性应用恩替卡韦治疗的25例患者中，化疗后出现HBV激活0例，4例患者肝功能损害Ⅰ～Ⅱ度，无患者出现Ⅲ～Ⅳ度肝功能损害，出现肝功能损害均与HBV无关。治疗组26例患者，化疗后14例患者出现HBV激活，4例患者出现肝功能损害Ⅰ～Ⅱ度，11例患者为Ⅲ～Ⅳ度肝功能损害，2例患者肝功能损害进行性加重而死亡，其中12例患者肝功能损害与HBV激活有关，两组比较差异有统计学意义（P0.01）。 结论 预防性应用恩替卡韦不仅能降低B细胞淋巴瘤患者化疗相关性HBV激活，而且能减少肝功能损害的发生。 　　[关键词] 恩替卡韦；B细胞淋巴瘤；利妥昔单抗；HBV激活 　　[中图分类号] R733 [文献标识码] A [文章编号] 1674-4721（2014）08（b）-0092-04 　　[Abstract] Objective To explore clinical effect on entecavir in the prevention for HBV activation in patients with B-cell lymphoma after R-CHOP chemotherapy. Methods A retrospective study was conducted on the clinical data of patients with B-cell lymphoma receiving R-CHOP chemotherapy in our hospital.The patients were assigned to the prevention group and treatment group according to the timing of entecavir application.The clinical characteristic and HBV activation was compared between the two groups respectively. Results 51 patients met inclusion criteria with 25 cases in the prevention group and 26 cases in the treatment group.Among the 25 patients given entecavir for preventive treatment，no patient had HBV activation，4 patients had class Ⅰ-Ⅱ liver function damage，no patient had class Ⅲ-Ⅳ liver function damage，liver function damage was not associated with HBV activation.Among the 26 patients in the treatment group，14 patients had HBV activation，4 patients had class Ⅰ-Ⅱ liver function damage，11 patients had class Ⅲ-Ⅳ liver function damage，2 patients died of progressive liver function damage，liver function damage was associated with HBV activation in 12 patients.There was statistical difference between the two groups（P0.01）. Conclusion Preventive treatment with entecavir does not only reduce chemotherapy-related HBV activation，but also reduce liver function damage in patients with B-cell lymphoma. 　　[Key words] Entecavir；B-cell ly