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目的探讨恩替卡韦联合拉米夫定对肿瘤并乙肝病毒感染患者化疗后乙肝病毒再激活的预防作用。方法选取广西科技大学第一附属医院2015年1月—2016年1月收治的肿瘤并乙肝病毒感染且行化疗患者82例,按照随机数字表法分为对照组和试验组,各41例。患者入院后均给予常规对症治疗及放化疗,对照组患者给予拉米夫定片治疗,试验组患者在对照组基础上给予恩替卡韦分散片治疗。比较两组患者治疗前及治疗后1、2、3周谷氨酸氨基转氨酶(ALT)定量检查及乙肝病毒脱氧核糖核酸(HBV-DNA)载量,并观察比较两组患者乙肝病毒再激活及不良反应反生情况。结果治疗前及治疗后1、2周,两组患者ALT水平比较,差异无统计学意义(P>0.05);治疗后4周,试验组患者ALT水平低于对照组(P<0.05)。治疗前及治疗后1、2周,两组患者HBV-DNA载量比较,差异无统计学意义(P>0.05);治疗后4周,试验组患者HBV-DNA载量低于对照组(P<0.05)。试验组患者乙肝病毒再激活率低于对照组(P<0.05)。两组患者治疗期间不良反应发生率比较,差异无统计学意义(P>0.05)。结论恩替卡韦联合拉米夫定应用于化疗后肿瘤并乙肝病毒感染患者中,可明显改善患者肝功能,减少乙肝病毒再激活率,且安全性好。
Objective To investigate the preventive effect of entecavir combined with lamivudine on the reactivation of hepatitis B virus after chemotherapy in patients with tumor and hepatitis B virus infection. Methods Totally 82 patients with tumor and hepatitis B virus infection who underwent chemotherapy in the First Affiliated Hospital of Guangxi University of Science and Technology from January 2015 to January 2016 were divided into control group and experimental group according to the random number table method, and each group had 41 cases. Patients were given conventional symptomatic treatment and radiotherapy and chemotherapy after admission, lamivudine tablets were given to patients in the control group and entecavir tablets were given on the basis of the control group. The levels of ALT and HBV DNA before and after treatment were compared between the two groups. The reactivation of hepatitis B virus Adverse reactions adverse reactions. Results There was no significant difference in ALT levels between the two groups before treatment and one and two weeks after treatment (P> 0.05). After 4 weeks of treatment, the ALT level in the experimental group was lower than that in the control group (P <0.05). Before and after treatment, the HBV-DNA load of the two groups had no significant difference (P> 0.05). After 4 weeks of treatment, the HBV-DNA load of the experimental group was lower than that of the control group (P <0.05). The reactivation rate of hepatitis B virus in the experimental group was lower than that in the control group (P <0.05). There was no significant difference in the incidence of adverse reactions between the two groups during treatment (P> 0.05). Conclusion The combination of entecavir and lamivudine in patients with tumor and hepatitis B virus infection after chemotherapy can significantly improve liver function, reduce the rate of HBV reactivation, and have good safety.