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目的:回顾性分析乙型肝炎病毒(HBV)感染在住院的血液系统疾病患者中分布情况及化疗后影响。方法:对205例血液系统疾病患者临床资料进行回顾性分析,根据血液系统疾病及乙肝病毒抗原、抗体检测结果不同分组,以200例同期体检人员为对照,统计总体乙肝病毒感染率及治疗后肝功能损害情况。结果:淋巴瘤组HBsAg阳性率为22.95%,与体检组及其他疾病组差异有统计学意义(P<0.05);治疗前肝功能异常发生率HBV感染组为14.67%,HBV未感染组的5.38%,差异有统计学意义(P<0.05);治疗后肝功能损害发生率HB-sAg阴性HBeAb、HBcAb阳性组为51.28%,HBV未感染组为22.31%,两者差异有统计学意义(P<0.05)。结论:淋巴瘤患者中HBV感染率明显增高。对予HBsAg阳性患者,早期应用抗病毒药物拉米夫定并加强护肝治疗能有效降低HBV-DNA激活及肝功能损害发生率。HBsAg阴性而HBeAb、HbcAb阳性患者临床医生应提高警惕,早期检测HBV-DNA,加强护肝治疗强度,定期监测HBV-DNA及肝功能。
Objective: To retrospectively analyze the distribution of Hepatitis B virus (HBV) infection in hospitalized patients with hematological diseases and the effect after chemotherapy. Methods: The clinical data of 205 patients with hematologic diseases were analyzed retrospectively. According to the results of blood system diseases and hepatitis B virus antigens and antibody test, 200 cases of medical staff of the same period were taken as control. The overall rate of hepatitis B virus infection and post-treatment liver Functional impairment. Results: The positive rate of HBsAg in lymphoma group was 22.95%, which was significantly different from that in the physical examination group and other disease groups (P <0.05). The incidence of liver dysfunction before treatment was 14.67% in HBV infected group and 5.38 %, The difference was statistically significant (P <0.05). After treatment, the incidence of hepatic impairment in HBsAg-negative HBeAb and HBcAb-positive group was 51.28% and that in HBV non-infected group was 22.31%, the difference was statistically significant (P <0.05). Conclusion: The HBV infection rate in patients with lymphoma is significantly higher. For HBsAg-positive patients, the early use of antiviral lamivudine and strengthen the treatment of liver can effectively reduce the incidence of HBV-DNA activation and liver dysfunction. HBsAg-negative HBeAb, HbcAb-positive patients clinicians should be vigilant, early detection of HBV-DNA, strengthen the strength of liver protection, regular monitoring of HBV-DNA and liver function.