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华西医学  2015 

淋巴瘤患者化学治疗前乙型肝炎病毒感染的筛查情况分析

DOI: 10.7507/1002-0179.20150130, PP. 455-459

Keywords: 淋巴瘤,乙型肝炎病毒,化学疗法,激活

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Abstract:

目的?探讨淋巴瘤患者化学治疗(化疗)前乙型肝炎病毒(HBV)感染的筛查率和化疗后HBV的激活情况及其影响因素。方法?对2010年6月-2012年7月于四川大学华西医院行化疗的449例淋巴瘤初治患者的HBV感染筛查情况进行回顾性分析。结果?淋巴瘤患者化疗前HBV筛查率为86.2%,转氨酶水平升高比转氨酶正常的患者化疗前的HBV筛查率更高(OR=2.509,P=0.040)。乙型肝炎病毒表面抗原(HBsAg)阳性的患者中,化疗后HBV激活率为16.1%(9/56),使用利妥昔单抗的患者HBV激活率更高(29.2%、6.3%,P=0.030),抗病毒治疗能明显降低HBV激活率(12.0%、50.0%,P=0.046)。HBsAg阴性/乙型肝炎核心抗体阳性的患者中发生2例HBV激活。结论?HBV激活在合并HBV感染的淋巴瘤患者中常见,尤其是对于使用利妥昔单抗治疗的患者。淋巴瘤患者化疗前应常规筛查HBV,预防性抗病毒治疗是降低HBV激活率的有效措施。

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