阿德福韦酯预防乙型肝炎携带的非霍奇金淋巴瘤化疗后致乙肝病毒再激活的临床分析

目的探讨阿德福韦酯预防性给药是否减少非霍奇金淋巴瘤化疗中相关性乙肝病毒再激活。方法本科2004～2009年收治的65例携带乙型肝炎病毒的非霍奇金淋巴瘤患者分为预防组30例,对照组35例。预防组在化疗前给予口服阿德福韦酯(10mg/d),至化疗后6个月,对照组患者未接受包括阿德福韦酯在内的核苷酸类似物治疗。比较化疗后乙肝病毒再激活、肝功能损害、化疗延迟等指标变化。结果预防组与对照组相比较在乙肝病毒再激活发生率、肝功能损害发生率、化疗延迟发生率、肝炎相关病死率方面的差异均有统计学意义(P<0.05)。结论预防性口服阿德福韦酯可以降低携带乙肝病毒的非霍奇金淋巴瘤患者乙肝病毒再激活的风险。

Role of prophylactic adefovir dipivoxil in non-Hodgkin lymphoma in HBV carriers undergoing chemotherapy

Objective To assess the incidence of HBV reactivation reduced by prophylactic adefovir dipivoxil in non-Hodgkin lymphoma HBV carriers receiving cytotoxic chemotherapy.Methods From 2004 to 2009,65 HBV carriers with NHL were divided into prophylactic group(n=30) and control group(n=35) according to the use of adefovir dipivoxil in a retrospective study.In prophylactic group,10 mg of daily oral adefovir dipivoxil was administered before the chemotherapy until 6 months after the completion of chemotherapy.Control group received no nucleotide analogue.The incidence of HBV reactivation,functional damage of liver,and disruption of chemotherapy were measured.Results The comparison between the two groups showed a statistically significant difference in the incidence of HBV reactivation,liver functional damage,disruption of chemotherapy,and hepatitis-associated mortality(all P<0.05).Conclusion The prophylactic use of oral adefovir dipivoxil could reduce the risk of HBV reactivation in HBV carriers with NHL.