拉米夫定在预防乙型肝炎携带的淋巴瘤患者化疗后肝炎发生中作用

The role of prophylactic lamivudine on chronic hepatitis B in HBV carriers with lymphoma after chemotherapy.

探讨慢性HBV携带的淋巴瘤患者化疗前预防应用拉米夫定在减少化疗后肝炎发生率以及严重程度方面的作用。40例患者化疗前及整个化疗期间口服拉米夫定,并持续用至化疗结束后至少8周以上；另外历史对照组116例患者未接受预防性拉米夫定口服。对二组患者肝炎发生率、严重性以及不良临床后果进行比较,对肝炎发生的危险因素进行分析。结果显示预防应用拉米夫定能够明显减少肝炎的发生率及明显改善患者接受化疗后出现的不良临床后果；并显示激素的应用是肝炎发生的高危因素。对HBV携带的淋巴瘤患者化疗前应预防使用拉米夫定,尤其对于接受含激素的化疗方案的患者。

To investigate the role of prophylactic lamivudone in reducing the incidence and severity of hepatitis B in lymphoma patients who were HBV carriers and received chemotherapy. The prophylactic lamivudine group consisted of 40 patients who were treated with oral lamivudine before and until at least 8 weeks after chemotherapy. The historical control group consisted of 116 patients who underwent chemotherapy without lamivudine treatment. The incidence and severity of hepatitis and other adverse clinical outcomes were compared between the two groups. Significant prognostic factors for the development of hepatitis （P = 0, 000）, less disruption of chemotherapy （ P = 0. 001 ）. In the control group, the factor associated with a higher risk of developing hepatitis was the use of prednisone. With the use of prophylactic lamivudine in chronic HBV carriers with lymphoma undergoing chemotherapy, the incidence and severity of hepatitis of liver damage were lower. The chemotherapy disruption rate as the result of severe hepatitis is also significantly decreased. The treatment should be considered for lymphoma patients who are chronic HBV carriers and planned for chemotherapy .