摘要
目的探讨乙型肝炎病毒(HBV)表面抗原(HBs Ag)阴性(-)伴核心抗体(Hbc Ab)阳性(+)非霍奇金淋巴瘤患者免疫化疗后肝炎病毒再激活的临床意义。方法选择2005年1月至2012年1月间就诊并接受2个以上疗程免疫化疗的HBs Ag(-)伴HBc Ab(+)非霍奇金淋巴瘤患者105例为研究对象,对其予以含利妥昔单抗的免疫化疗,观察免疫化疗后HBV再激活的发生情况。结果 105例HBs Ag(-)伴HBc Ab(+)非霍奇金淋巴瘤患者中,HBV表面抗体(HBs Ab)(+)者67例,占63.8%。105例患者中,肝功能损害Ⅰ~Ⅲ度者13例,其中1例患者出现了HBV再激活(1.0%),12例证实与HBV再激活引起肝损害无关。1例出现了HBV再激活患者为男性、50岁,病理组织学提示为非霍奇金氏淋巴瘤,弥漫大B细胞性,在4次化疗后10 d发生HBV再激活,经治疗后病情好转。结论 HBs Ag(-)伴HBc Ab(+)淋巴瘤患者免疫化疗后肝炎病毒再激活的临床发生率相对较小,目前对该类患者仍以常规HBV DNA检查、肝功能监测为主,以便更早的发现HBV携带者及感染者。
Objective To statistics the status of hepatitis virus reactivation after immune chemotherapy in hepatitis B surface antigen( HBs Ag)(-) with hepatitis B core antibody( HBc Ab)( +) patients with non-hodgkin's lymphoma. Methods Between January 2005 and January 2012 in Affiliated Hospital of Beihua University,105 cases who received more than 2 courses of immune chemotherapy in HBs Ag(-) with HBc Ab( +) patients with non-hodgkin's lymphoma as the research object. The patients were received the immune chemotherapy,including rituximab,to observe the immune chemotherapy after the happening situation of hepatitis B virus( HBV) reactivation. Results Among 105 cases of HBs Ag(-) with HBc Ab( +)in patients with non-hodgkin's lymphoma,67 cases( 63. 8%) had HBV surface antigen antibody( HBs Ab)( +). There were 13 cases of liver damage in 105 patients,and 1 patients( 1. 0%) had HBV reactivation,and 12 cases had no related to HBV reactivation. One case of HBV reactivation was male,50-year old.Pathological examination showed non-Hodgkin's lymphoma,diffuse large B cell,and HBV reactivation occurred at 10 d after 4 cycles of chemotherapy. After treatment,the condition improved. Conclusions Clinical incidence of HBV reactivation after immune chemotherapy is relatively small in HBs Ag(-) with Hbc Ab( +) patients with non-hodgkin's lymphoma. At present,the patients are still given HBV DNA and liver function monitoring,in order to earlier find HBV carriers and HBV patients.
出处
《中国肿瘤临床与康复》
2015年第11期1318-1320,共3页
Chinese Journal of Clinical Oncology and Rehabilitation
关键词
淋巴瘤
免疫化疗
乙型肝炎病毒
再激活
Lymphoma
Immune chemotherapy
Hepatitis B virus
Reactivation