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目的了解乙型肝炎病毒(HBV)感染在恶性血液系统疾病患儿的分布,以期能为临床诊治提供参考。方法回顾性分析2006年8月-2011年8月在医院首次住院治疗的恶性血液系统疾病患儿187例为血液病组,同期200例体检儿童为对照组,比对分析HBV感染情况,数据采用SPSS13.0进行分析。结果血液病组HBV感染率、HBsAg阳性率为33.69%、24.60%,高于对照组的5.50%、0.50%(P<0.05);乙型肝炎五项标志物检测结果显示,HBsAb阳性率最高,为43.85%,阳性率最低的为HBsAg+HBeAg+HBcAb、HBsAg+HBeAb+HBcAb模式,阳性率为1.60%,未发现乙型肝炎五项标志物全部阳性患儿;治疗前肝功能异常率为27.81%高于治疗后肝功能异常率为41.71%;治疗前、治疗后肝功能异常率HBV感染为42.86%、61.90%,无HBV感染患儿为20.16%、31.45%。结论 HBV感染在恶性血液系统疾病患儿中发生率较高,在化疗后患儿肝功能损害会有所加重,化疗期间需要加强保肝治疗及定期监测HBV再激活。
Objective To understand the distribution of hepatitis B virus (HBV) infection in children with hematologic malignancies, with a view to provide a reference for clinical diagnosis and treatment. Methods A retrospective analysis of 187 hospitalized patients with hematologic malignancies admitted to hospital for the first time from August 2006 to August 2011 was performed as blood disease group and 200 healthy children as control group during the same period. SPSS13.0 for analysis. Results The positive rates of HBsAg and HBsAg in hematological patients were 33.69% and 24.60%, which were higher than those in control group (5.50% and 0.50%, P <0.05). The results of five markers of hepatitis B showed that the positive rate of HBsAb was the highest, Was 43.85%, the lowest positive rate was HBsAg + HBeAg + HBcAb, HBsAg + HBeAb + HBcAb pattern, the positive rate was 1.60%, did not find all five positive markers of hepatitis B in children; liver dysfunction before treatment was 27.81 % Higher than the abnormal liver function after treatment was 41.71%; before treatment, the HBV infection rate of abnormal liver function after treatment was 42.86%, 61.90%, 20.16%, 31.45% in children without HBV infection. Conclusion The incidence of HBV infection is high in children with hematologic malignancies. The liver damage in children with chemotherapy will be aggravated. Hepatitis B treatment should be intensified during chemotherapy and HBV reactivation should be monitored periodically.