肺癌并HBV携带者化疗同时应用恩替卡韦的效果

EFFECT OF ENTECAVIR ON LUNG CANCER IN HEPATITIS B VIRUS CARRIERS DURING CHEMOTHERAPY

目的寻找预防和治疗肺癌并发乙型肝炎病毒（HBV）携带者化疗后肝损害的有效药物。方法选取肺癌并发HBV携带者70例,随机分为两组,各35例。观察组化疗的同时预防性应用恩替卡韦,对照组仅化疗,比较两组化疗2、4周期后的肝功能损伤程度和HBV再激活率差异。结果化疗2、4周期后,两组血清谷丙转氨酶（ALT）、谷草转氨酶（AST）、总胆红素（TBIL）较化疗前均升高（F=2.64~15.27,P〈0.05）,观察组血清ALT、AST、TBIL明显低于对照组（t=2.14~5.31,P〈0.05）;两组均发生HBV再激活和化疗延迟或中断情况,观察组的发生率低于对照组（χ~2=4.200、3.621,P〈0.05）。结论肺癌并发HBV携带者化疗同时应预防性使用恩替卡韦以减轻肝功能损伤。

Objective To look for effective drugs for prevention and treatment of liver damage after chemotherapy for lung cancer in hepatitis B virus（HBV）carriers. Methods Lung cancer in 70 HBV carries were selected and evenly randomized to observation group and control group.Patients in the observation group received chemotherapy,and at the same time,prophylactic entecavir was added.Those in the control group received only chemotherapy.A comparison between the two groups in terms of impairment of liver function and reactivation rate of hepatitis B was conducted-2and 4weeks after chemotherapy. Results After2-and 4-week chemotherapy,serum levels of ALT,AST and TBIL in both groups were higher than that before chemotherapy（t=2.64-15.27,P〈0.05）,and that in the observation group were much lower than that in the control（F=2.14-5.31,P〈0.05）.HBV reactivation and delayed or terminated chemotherapy occurred in both groups,but the incidence was lower in the observation group versus that in the control group（χ2=4.200,3.621;P〈0.05）. Conclusion Simultaneous use of entecavir in chemotherapy for lung cancer in hepatitis B virus carriers may relieve the impairment of their liver function.