乙型肝炎病毒在恶性血液系统疾病患儿中的分布

Distribution of hepatitis B virus in children with malignant blood diseases

目的了解乙型肝炎病毒(HBV)感染在恶性血液系统疾病患儿的分布,以期能为临床诊治提供参考。方法回顾性分析2006年8月-2011年8月在医院首次住院治疗的恶性血液系统疾病患儿187例为血液病组,同期200例体检儿童为对照组,比对分析HBV感染情况,数据采用SPSS13.0进行分析。结果血液病组HBV感染率、HBsAg阳性率为33.69%、24.60%,高于对照组的5.50%、0.50%(P<0.05);乙型肝炎五项标志物检测结果显示,HBsAb阳性率最高,为43.85%,阳性率最低的为HBsAg+HBeAg+HBcAb、HBsAg+HBeAb+HBcAb模式,阳性率为1.60%,未发现乙型肝炎五项标志物全部阳性患儿;治疗前肝功能异常率为27.81%高于治疗后肝功能异常率为41.71%;治疗前、治疗后肝功能异常率HBV感染为42.86%、61.90%,无HBV感染患儿为20.16%、31.45%。结论 HBV感染在恶性血液系统疾病患儿中发生率较高,在化疗后患儿肝功能损害会有所加重,化疗期间需要加强保肝治疗及定期监测HBV再激活。

OBJECTIVE To understand the distribution of hepatitis B virus（HBV）infections in children with malignant blood diseases in order to provide a reference for clinical diagnosis and treatment.METHODS Totally 187 children with malignant blood diseases hospitalized for the first time during Aug.2006 to Aug.2011 were taken as the blood disease group and were retrospectively analyzed,meanwhile 200 children for physical examinations during the same period were taken as the control group,the two groups were compared for the situation of HBV infection,data were analyzed with SPSS 13.0.RESULTS The HBV infection rate,and the HBsAg positive rate was 33.69%,24.60% in the blood disease group,higher than 5.50%,0.50% in the control group（P0.05）.Detection of five indicators for hepatitis B showed the HBsAb positive rate was the highest（43.85%）,and the lowest（1.60%）was seen in HBsAg,HBeAb＋HBcAb,HBsAb＋HBcAb modes.There were no children detected to be positive for all five indicators for hepatitis B.The abnormal rate for liver function was 27.81% before treatment,higher than 41.71% after treatment.The HBV infection rate before and after treatment was 42.86% and 61.90%,the proportion of children without HBV infection before and after treatment was 20.16% and 31.45%.CONCLUSION HBV infection has a higher incidence in children with malignant blood diseases.As liver damage after chemotherapy could be increased,there is needed to strengthen liver-protecting treatment during chemotherapy and regular monitoring for HBV reactivation.