中西医防治风湿疾病应用免疫抑制剂致乙型肝炎病毒再激活研究概况

Prevention and Control of Traditional Chinese and Western Medicine Rheumatism Disease Application Immunosuppressants Induced by Hepatitis B Virus Reactivation

抗风湿药氯喹、硫唑嘌呤、甲氨喋呤、柳氮磺胺吡啶等都可导致乙型肝炎病毒（HBV）再激活，联合小剂量泼尼松亦可导致HBV再激活．免疫抑制剂减量或停用后发生HBV再激活的较多。使用免疫抑制剂后HBV活化概率24％～78％．进一步产生黄疸性肝炎10％～63％．肝衰竭4％～60％。HBsAg（＋）患者化疗后可发生HBV再激活，出现黄疸型肝炎非致死性肝衰竭、病死的概率分别为22．2％、3．7％和3．7％。故预防HBV再激活十分重要。将要接受化疗、免疫抑制治疗或器官移植者都应监测病毒DNA和肝功能、筛查乙肝标志物。早期、提前抗病毒治疗效果优于发生HBV再激活后再干预．无论HBeAg（＋）与否以及HBV-DNA水平高低，都应进行预防性抗病毒治疗。可以用中医扶正固本法提升人体正气．

Anti-rheumatism medicine chloroquine, azathioprine, methotrexate, willow nitrogen sulphanilamide pyridine, etc all can lead to hepatitis b virus （ HBV ） reactivation, in combination with small dose of prednisone can also lead to HBV reactivation. Immune inhibitors on or after the outage of HBV reactivation. HBV activation rate is 24% - 24% after using immunosuppressant, further produce 10% -63% of jaundice hepatitis c, liver failure by 4% - 60% . HBsAg （ ＋ ） can occur after chemotherapy in patients with HBV reactivation, appear icteric model hepatitis, nonfatal liver failure, the probability of illness were 22.2%, 3.7% and 3.7%, respectively. So it is very important to prevent HBV reactivation. Will be treated with chemotherapy, immunosuppressive therapy or transplant should be monitoring and liver function, screening for hepatitis h virus DNA markers. Early, early antiviral treatment effect is better than that of HBV reactivation occurred after the intervention. Regardless of HBeAg （ ＋ ） and HBV DNA level, should be preventive antiviral treatment. Can use Chinese medicine centralizer up method to improve the human body vital qi.