摘要
目的：研究肝细胞癌（ HCC）行经皮肝穿刺肝肿瘤微波消融术（ PMWA）联合经导管化疗栓塞术（ TACE）治疗后乙型肝炎病毒（ HBV）再激活的临床特点以及联合治疗前抗病毒治疗对HBV再激活的影响。方法根据术前是否行抗病毒治疗180例接受PMWA联合TACE的HCC患者，分为抗病毒治疗组（A组，n＝90）和对照组（B组，n＝90）。观察两组患者接受联合疗法前后HBV-DNA变化，了解联合疗法前后的HBV再激活情况及抗病毒治疗对HBV再激活的影响。结果抗病毒治疗组联合疗法后的HBV再激活率显著低于对照组[8．2％（7／90）比20．0％（18／90），P＜0．05]。联合疗法术前HBV DNA＞104 copies／ml是导致HBV再激活的唯一的独立危险因素（ P＜0.05）。结论HBV表面抗原携带者接受联合疗法术后具有较高的HBV再激活率，而抗病毒治疗能够显著降低HBV再激活率。因此，对HBV DNA＞104 copies／ml的患者应在联合疗法术前进行抗病毒治疗。
Objective To investigate the characteristics of hepatitis virus B （ HBV） reactivation af-ter combined percutaneous microwave ablation （ PMWA ） and transcatheter arterial chemoembolization （ TACE） in patients with hepatocellular carcinoma （ HCC） and to study the therapeutic role of preoperative antiviral therapy .Methods The data on 180 HCC patients who were treated with the combined therapy were analyzed .The antivirus group （ n=90 ） received antiviral therapy , while the control group （ n=90 ） did not.HBV-DNA was used to study the reactivation status of HBV after the combined therapy and the role of antiviral therapy .Results The incidence of HBV reactivation was significantly lower in the antivirus group （8.2%, 7/90） than the control group （20.0%, 18/90, P〈0.05）.A preoperative HBV-DNA level above 104 copies/ml was the only independent risk factor of HBV reactivation （P〈0.05）.Conclusions The HBV reactivation rate was relatively high in patients with HBV-related HCC after combined PMWA and TACE.Preoperative antiviral therapy significantly reduced HBV reactivation and thus it should be adminis -trated especially to HCC patients with a preoperative HBV-DNA level above 104 copies/ml.
出处
《中华肝胆外科杂志》
CAS
CSCD
北大核心
2016年第6期370-373,共4页
Chinese Journal of Hepatobiliary Surgery
基金
国家自然科学基金项目（81301302）
上海市科委基金西医引导项目（15411966100）
关键词
微波消融
化疗栓塞
肝细胞癌
肝炎病毒
乙型
抗病毒药
Microwave ablation
Chemoembolization
Hepatocellular carcinoma
Hepatitis vi-rus B
Antivirus therapy
