苦参碱治疗肝癌化疗乙肝病毒再激活的临床观察

Efficiency of Matrine on hepatitis B virus replication in HBsAg^+ hepatocellular carcinoma after chemotherapy.

研究肝癌化疗对乙肝活动状态的影响及苦参碱的作用。检测89例肝癌患者的血清乙型肝炎病毒标志物及其HBV DNA定量,分为2组,均采用GP方案(吉西他滨+顺铂)化疗,单纯化疗者42例,联合苦参碱者47例,化疗期间、化疗后8周监测HBV DNA及标志物、肝功能。化疗后HBV DNA量较化疗前增加(P<0．01),乙肝病毒再激活与肝炎活动相关,联用苦参碱可减轻肝功能损害,与单纯化疗组相比差异有显著性,但对降低血清HBV DNA载量作用不明显。肝癌化疗可引起乙肝病毒再激活,并导致肝炎活动,苦参碱能保护肝细胞,改善肝功能,对乙肝病毒再激活引起的肝损害有保护作用,但抗病毒作用不明显。

To study the Gepatitis B virus replication status in patients undergoing chemotherppy with hepatocellular carcinoma and the intefering effect of Matrine. 89 HBsAg - positive patients with inoperable hepatocellular carcinoma underwent systemic chemotherapy. They were randomly divided into tow groups. 42 patients were only treated GP program （gemeitabine and cisplatin）, while the other 47 patients treated with GP combined with Matrine. The serum HBV DNA quantities, HBV signs and liver function were tested during and after chemotherapy. The quantity of serum HBV DNA increased significantly after chemotherapy （P 〈 0. 01 ）. Reactivation of HBV was related with hepatitis activity. The therppy of GP com- bined with Matrine can alleviate the liver injury, but have no marked effect to decrease HBV quantities. The chemotherapy in hepatoceltular carcinoma can induce increasing of HBV quantities and activation of hepatitis. Matrine can protect the liver cells and improve liver function. But it have no marked effect to inhibit HBV.