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预防性抗病毒对TACE治疗的HBV DNA阴性乙肝相关性肝癌的效果

周佳美   

  1. 保定市第二中心医院消化内科
  • 收稿日期:2012-08-13 修回日期:2013-04-20 出版日期:2013-09-15 发布日期:2013-09-15
  • 通讯作者: 周佳美

The Effects of Preemptive Antiviral Therapy on HBV DNA Negative HBV-Related Hepatocellular Carcinoma Patients Receiving Transcatheter Arterial Chemoembolization

ZHOU Jia mei   

  1. The Second Central Hospital of Baoding
  • Received:2012-08-13 Revised:2013-04-20 Published:2013-09-15 Online:2013-09-15
  • Contact: ZHOU Jia mei

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摘要：

【摘要】目的  探讨预防性抗病毒治疗对接受肝动脉化疗栓塞术（TACE）的乙型肝炎病毒（HBV）DNA阴性乙肝相关性肝细胞癌的效果。方法   HBV DNA阴性乙肝相关性肝癌并接受TACE治疗的患者54例，其中TACE治疗前1周开始应用抗病毒药物的30例为治疗组，TACE前未抗病毒治疗，TACE术后病毒转阳才抗病毒者24例为对照组。观察2组TACE术后HBV DNA转阳数、HBV DNA转阳时距离最后一次TACE的时间、异常ALT数、ALT和AST峰值、病毒再活化所致肝衰竭数等。结果  治疗组HBV DNA转阳数、异常ALT数、病毒再活化导致ALT异常数、ALT峰值及AST峰值均少于对照组（P＜0.05）。治疗组无一例患者发生病毒转阳所致的肝衰竭，对照组有4例发生病毒转阳所致肝衰竭。2组累积生存率差异无统计学意义(P=0.071)。结论  对接受TACE治疗的HBV DNA阴性乙肝相关性肝细胞癌患者，预防性抗病毒治疗可以抑制病毒复制，维持肝功能稳定，降低病毒转阳所致的肝衰竭发生

关键词: 肝炎, 乙型, 慢性, 抗病毒药, 癌, 肝细胞, 肝动脉, 抗肿瘤联合化疗方案

Abstract:

[Abstract]   Objective   To investigate the effects of prophylactic antiviral therapy for HBV DNA negative HBV-relat-
ed hepatocellular carcinoma (HCC) patients undergoing hepatic arterial chemoembolization (TACE).Methods   Fifty-four consecutive patients with HBV-related HCC and received TACE were enrolled in this study. Thirty patients received preemptive antiviral drugs before TACE were defined as the treatment group. Twenty-four patients, who did not use antiviral drugs until HBV reactivation after TACE, were included in control group. The incidence of HBV reactivation, duration from HBV DNA positive point to the last time of TACE, the occurrence of abnormal alanine aminotransferase (ALT) caused by HBV reactivation, the peak of aspartate aminotransferase (AST) and the number of liver failure caused by HBV reactivation were observed after TACE in two groups.Results   The incidence of HBV reactivation, the occurrence of abnormal ALT, the occurrence of abnormal ALT caused by HBV reactivation, the peak ALT and peak AST were significantly lower in treatment group than those of control group (P<0.05). No liver failure caused by HBV reactivation was found in treatment group. There were four patients with liver failure caused by HBV reactivation in control group. There was no significant difference in cumulative survival rate between two groups (P=0.071). Conclusion   It is suggested that preemptive antiviral therapy can prevent the reactivation of hepatitis B virus, prevent the deterioration of liver function，and decrease the occurrence of liver failure caused by HBV reactivation in patients receiving TACE

Key words: hepatitis B, chronic, antiviral agents, carcinoma, hepatocellular, hepatic artery, antineoplastic combined chemotherapy protocols, 抗肿瘤联合化疗方案