乙肝病毒感染的恶性淋巴瘤患者化疗后肝功能变化

目的:研究乙肝病毒(hepatitis B virus,HBV)感染的恶性淋巴瘤患者化疗后肝功能变化。方法:收集本院确诊HBV感染恶性淋巴瘤接受化疗患者278例,检测并比较HBV感染合并霍奇金淋巴瘤(hodgkin’s lymphoma,HL)及非霍奇金淋巴瘤(non hodgkin lymphoma,NHL)患者化疗后肝功能变化特点。结果:HBV感染的恶性淋巴瘤患者化疗后肝功能损害发生率47.8%(133/278)。HL组肝功能损害发生率37.0%,低于NHL组的54.7%(χ~2=8.263,P=0.003),HL组重度肝功能损害(Ⅲ度+Ⅳ度)率3.7%(4/108),低于NHL组的13.5%(23/170)(χ~2=7.271,P=0.005)。治疗前HBV-DNA>104copy/m L患者肝功能损害发生率42.3%(58/137),<104 copy/m L患者肝功能损害发生率53.2%(75/141),差异无统计学意义(χ~2=3.282,P=0.045);但是治疗前HBV-DNA>104 copy/m L患者重度肝功能损害发生率14.6%(20/137)高于<104 copy/m L患者重度肝功能损害发生率5.0%(7/141)(χ~2=7.355,P=0.006)。结论:恶性淋巴瘤合并乙肝病毒感染化疗后肝功能损害明显,NHL患者更易感染,临床诊疗时需注意监测并及时处理。

Changes of liver function in patients of malignant lymphoma with hepatitis B virus infection after chemotherapy

Objective:Changes of liver function in patients of malignant lymphoma with hepatitis B virus (HBV) infection after chemotherapy.Methods:278 cases of patients of malignant lymphoma with HBV infection receiving chemotherapy in our hospital were collected,the changes of liver function in patients with hepatitis B virus infection combined with Hodgkin's lymphoma (HL) and non Hodgkin lymphoma (NHL) were detected and compared.Results:The incidence of liver damage in patients with hepatitis B virus infection after chemotherapy was 47.8％ (133/278).The incidence of liver function damage in HL group was 37％,was less than 54.7％ in group NHL (x2=8.263,P =0.003),The rate of severe liver damage in HL group was 3.7％ (4/108),was less than 13.5％ in group NHL (23/170)(x2 =7.271,P =0.005).The incidence of liver damage in patients with HBV-DNA ＞ 104 copy/mL before treatment was 42.3％ (58/137),and the incidence of liver damage in patients with ＜ 104 copy/mL was 53.2％ (75/141),There was no statistically significant difference (x2 =3.282,P =0.045);But the incidence rate of severe liver function damage in patients with HBV-DNA ＞ 104copy/mL before treatment was14.6％ (20/137),higher than incidence rate of severe liver function in patients with damage ＜ 104 copy/mL (5.0％,7/141) (x2 =7.355,P =0.006).Conclusions:The liver function damage in patients with malignant lymphoma complicated with hepatitis B virus infection is obvious,NHL patients more susceptible,Attention should be paid to monitoring and timely treatment in clinical diagnosis.