核苷类抗病毒治疗对慢性乙型肝炎相关性肝癌患者术后预后影响.docVIP

核苷类抗病毒治疗对慢性乙型肝炎相关性肝癌患者术后预后影响 　　摘要： 目的 探讨核苷类抗病毒治疗对慢性乙型肝炎（以下简称“慢乙肝”）相关性肝癌患者术后预后的影响。 方法 回顾性分析2010年3月至2014年3月间浙江省宁波区奉化人民医院收住的100例乙型肝炎病毒-脱氧核糖核酸（HBV-DNA）阳性的慢乙肝相关性肝癌术后患者，50例对照组采用单纯手术切除或加肝动脉化疗栓塞术（TACE）治疗，50例治疗组采用手术切除或加TACE术后核苷类抗病毒治疗。结果 治疗2年和3年结果显示，治疗组和对照组HBV-DNA清除率分别为100%和0%，两组差异有统计学意义（P0.01）。治疗组2年和3年复发率均明显低于对照组。治疗组2年及3年生存率分别为50.0%及46.0%，而对照组分别为30.0%及24.0%，两组差异有统计学意义（P0.05）。 结论 核苷类药物抗病毒治疗对慢乙肝相关性肝癌术后患者能抑制HBV-DNA复制，最大限度的延缓复发，提高患者生存率。 　　关键词： 抗病毒药；慢性乙型肝炎；肝癌；预后 　　Nucleoside antiviral therapy for HBV-related hepatic carcinoma： Observation of post-operative prognosis 　　WANG Ya-fen， ZHOU Jian-fang ，YANG Shan-ming 　　Fenghua District people’s Hospital of Zhejiang Province， Ningbo City， Fenghua 315500） 　　Abstract： [Objective] To evaluate the nucleoside anologues antiviral therapy clinical outcome for HBV-related primary hepatic carcinoma patients after hepatectomy. [Methods] The clinical data was collected on 100 cases of HBV-related carcinoma after hepatectomy that were selected from March 2010 to March 2014 in the hospital. Out of them， 50 cases were retrospectively analyzed as control group receiving hepatic transarterial chemoembolization （TACE ） surgery and the other 50 cases as treatment group had TACE surgery followed by nucleoside analog treatment .[Results] After two and three years of treatment ， the HBV-DNA negativity was 100% and 0% in treatment and control group respectively （p0.05） ，Furthermore， recurrenes rate were decreased in treatment group .The 2 and 3 years of survival rates were 50.0% and 46.0% in the treatment group and 30.0% and 24.0%. in the control group respectively（p0.05）. [Couclusion]The nucleoside anti-viral treatment for HBV-related primary hepatic carcinoma patients after hepatectomy effectively inhibits the replication of HBV， uttermostly delays recurrence and improves the patient’s survival rate. 　　Key words： antiviral agents ； chronic hepatitis B； liver carcinoma ； clinical outcome. 　　慢性乙型肝炎（chronic hepatitis B，CHB，以下?称“慢乙肝”）相关性肝癌临床上首选手术治疗，但术