摘要
目的:对比观察拉米夫定及恩替卡韦在预防和治疗非霍奇金淋巴瘤(non-Hodgkin lymphoma,NHL)合并慢性乙型肝炎病毒(HBV)感染的患者化疗期间出现HBV再激活的有效性。方法:自2006年6月至2010年6月,共收集NHL合并HBV感染患者84例,在化疗同时服用拉米夫定(100mg/d)或恩替卡韦(0.5mg/d),就组间病毒学突破率,原发性无应答率、病毒学突破相关性肝炎突发等方面进行对比。结果:抗乙肝病毒治疗前HBV DNA<103copies/mL组,服用拉米夫定或恩替卡韦的病毒学突破率、肝炎突发率无统计学差异(P>0.05)。抗乙肝病毒治疗前HBV DNA>103 copies/mL组,服用拉米夫定的患者病毒学突破率为34.2%,原发耐药率为10.5%,肝炎突发率为26.3%,肝衰竭发生率为2.6%;服用恩替卡韦的患者上述指标分别为4.2%、0%、0%、0%,两者病毒学突破率及肝炎突发率有统计学差异(P<0.05)。结论:NHL并HBV感染患者抗乙肝病毒治疗前HBV DNA<103 copies/mL,拉米夫定和恩替卡韦疗效相当;抗乙肝病毒治疗前HBVDNA>103 copies/mL的患者恩替卡韦有更低的病毒学突破率及肝炎突发率,能更好地保证化疗的顺利进行。
Objective To investigate the efficacy of lamivudine and entecavir in preventing and treating HBV reaetivation in patients with non-Hodgkin lymphoma （NHL） during chemotherapy stage. Methods Clinical data of 84 NHL patients with HBV infection （from July 2006 to July 2010） were analyzed retrospectively. Each patient take lamivudine （100 rag/d） or entecavir（0.5 mg/d）. The rate of virological breakthrough, rate of primary non-respons, rate of chemical-therapy related hepatitis flare were compared in each group. Results In base line HBV DNA 〈 103 copies/mL group, lamivudine and entecavir showed no significant difference, with both virological breakthrough rate and hepatitis flare rate （P 〉 0.05 ）. In base line HBV DNA 〉 103 copies/mL group, the virological breakthrough rate was 34.2%, primary non-respons rate was 10.5%, the hepatitis flare rate was 26.3%,and the liver falure rate was 2.6% in patients treated with lamivudine ; and the datas in entecavir-treated group were 4.2%, 0%, 0%, 0%, respectively. Both virological breakthrough rate and hepatitis flare rate between two groups showed significant difference （P 〈 0.05）. Conclusions The efficacy of lamivudine and entecavir in preventing and treating HBV reactivation in patients with non-Hodgkin lymphoma are similar in patients whose base line were HBV DNA 〈 103 eopies/mL. In patients whose base line were HBV DNA 〉 103 copies/mL, Entecavir can more effectivly prevent HBV reactivation than lamivudine.
出处
《实用医学杂志》
CAS
北大核心
2011年第12期2225-2227,共3页
The Journal of Practical Medicine
