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1、恩替卡韦治疗非霍奇金淋巴瘤相关性HBV再激活疗效观察作者单位:天津市传染病医院,天津市肝病研究所300192。Email:fenghongling1116@sohu.com。冯洪玲,女,1980-,天津人,硕士,住院医师,主要从事肝脏疾病治疗及研究。冯洪玲唐克诚李谦袁桂玉杨积明【摘要】目的探讨恩替卡韦(entecavir,ETV)治疗非霍奇金淋巴(non-Hodgkin’slymphoma,NHL)相关性HBV再激活的疗效。方法本文系回顾性研究,将34例NHL相关性HBV再激活患者分为两组,ETV
2、0.5mg/天组、恩替卡韦1.0mg/天组。观察患者病情变化、化疗中断、病死率及临床转归。于治疗后2周、4周、8周、12周、24周监测血清HBVDNA水平、HBV标志物、肝功能变化。并观察抗病毒治疗中不良事件发生情况。结果治疗24周时,ETV可以降低此类患者化疗中断的发生率及肝炎相关病死率。且ETV表现出明显的抗病毒活性,治疗12周后,HBVDNA转阴率达36.7%,监测至24周,无病毒反弹病例。此外,ETV1.0mg/天组较ETV0.5mg/组,效果更佳。HBVDNA载量(PCR定量),2周时1
3、.0mg/天组平均降低3.40log10,0.5mg/天组下降1.86log10(p=0.000),4周、8周、12周时HBVDNA仍在下降,1.0mg/天组疗效更佳(p=0.000);血清ALT水平,1.0mg/天组优于0.5mg/天组(p=0.000);两组患者化疗中断的发生率,为11.1%VS.43.8%,1.0mg/天更低,差别有统计学意义(p<0.05)。而不良事件发生率、死亡率基本相似。结论ETV1.0mg/天组对于NHL相关性HBV再激活的抗病毒治疗具有良好的前景。【关键词】恩替卡韦
4、;肝炎病毒,乙型;乙型肝炎病毒再激活;治疗TheefficacyoftheantiviraltherapyofETVonchronichepatitisBinHBVcarrieswithNHLafterHBVreactivationFENGHong-ling,TANGke-cheng,LIqian,YUANGui-yu,YANGJi-mingTianjinInfectiousDiseaseSpecialtyHospital,Tianjin300192,ChinaCorrespondingautho
5、r:FENGHong-ling,Email:fenghongling1116@sohu.com【abstract】ObjectiveThestudywastoevaluatetheefficacytherapyofETVonchronichepatitisBinHBVcarrierswithNHLafterHBVreactivation.MethodsRecordsofNHLpatientswithchronicHBVinfection,treatedwithstandardchemotherap
6、yfromJan,2006toOct,2007,werereviewedtoanalyzetheantiviraltherapyofETV.34patientsweretreatedwithETV1.0mg(18patients)andETV0.5mg(16patients).Theresponseeffectsaftertreatmentfor24weeks,forexample,thecriticalincidenceofadverseevents(AEs)、themortalitywereo
7、bserved.HBVDNAlevels,theleverfunctionsandHBVMweremeasuredatweeks2,4,8,12and24.ResultETVcouldacceleratetheameliorativeofliverfunction,decreaseHBVDNAlevelandshortencourseofdisease.TheHBVDNAnegativerateswererespectively36.7%at12weeksoftreatment.Atthelate
8、r24weeks,thesuppressionofviralreplicatiorwasunobserved.Attheinitial2weeks,themeanHBVDNAleveldecreased3.40log10copies/ml(byPCFassay)frombaselineinETV1.0mgVS.1.86log10copies/mlin0.5mggroups(p=0.000).Theameliorationofliverfunctionwasgreaterfor0.5