乙肝病毒感染的恶性淋巴瘤患者化疗后肝功能变化

Changes of liver function in patients of malignant lymphoma with hepatitis B virus infection after chemotherapy

目的:研究乙肝病毒(hepatitis B virus,HBV)感染的恶性淋巴瘤患者化疗后肝功能变化。方法:收集本院确诊HBV感染恶性淋巴瘤接受化疗患者278例,检测并比较HBV感染合并霍奇金淋巴瘤(hodgkin’s lymphoma,HL)及非霍奇金淋巴瘤(non hodgkin lymphoma,NHL)患者化疗后肝功能变化特点。结果:HBV感染的恶性淋巴瘤患者化疗后肝功能损害发生率47.8%(133/278)。HL组肝功能损害发生率37.0%,低于NHL组的54.7%(χ~2=8.263,P=0.003),HL组重度肝功能损害(Ⅲ度+Ⅳ度)率3.7%(4/108),低于NHL组的13.5%(23/170)(χ~2=7.271,P=0.005)。治疗前HBV-DNA>104copy/m L患者肝功能损害发生率42.3%(58/137),<104 copy/m L患者肝功能损害发生率53.2%(75/141),差异无统计学意义(χ~2=3.282,P=0.045);但是治疗前HBV-DNA>104 copy/m L患者重度肝功能损害发生率14.6%(20/137)高于<104 copy/m L患者重度肝功能损害发生率5.0%(7/141)(χ~2=7.355,P=0.006)。结论:恶性淋巴瘤合并乙肝病毒感染化疗后肝功能损害明显,NHL患者更易感染,临床诊疗时需注意监测并及时处理。

Objective： Changes of liver function in patients of malignant lymphoma with hepatitis B virus （HBV） infection after chemotherapy. Methods：278 cases of patients of malignant lymphoma with HBV infection receiving chemotherapy in our hospital were collected,the changes of liver function in patients with hepatitis B virus infection combined with Hodgkin＇ s lymphoma （HL） and non Hodgkin lymphoma （NHL） were detected and compared. Results：The incidence of liver damage in patients with hepatitis B virus infection after chemotherapy was 47. 8% （ 133/278）. The incidence of liver function damage in HL group was 37% , was less than 54.7% in group NHL （χ^2=8. 263,P =0.003）,The rate of severe liver damage in HL group was 3.7% （4/108）,was less than 13.5% in group NHL （23/170）（χ^2= 7. 271 ,P = 0. 005 ）. The incidence of liver damage in patients with H BV-DNA 〉 104 copy/mL before treatment was 42.3% （58/137） , and the incidence of liver damage in patients with 〈 104 copy/mL was 53.2% （75/141） , There was no statistically significant difference （X2 = 3. 282 ,P = 0. 045） ; But the incidence rate of severe liver function damage in patients with HBV-DNA 〉 104copy/mL before treatment wasl4.6% （20/137） ,higher than incidence rate of severe liver function in patients with damage 〈 104 copy/mL （5.0% ,7/141 ） （χ^2= 7. 355 ,P = 0. 006 ）. Conclusions ： The liver function damage in patients with malignant lymphoma complicated with hepatitis B virus infection is obvious, NHL patients more susceptible,Attention should be paid to monitoring and timely treatment in clinical diagnosis.