内科

目的探讨利妥昔单抗联合化疗（R-CHOP方案）治疗非霍奇金淋巴瘤（NHL）合并乙型肝炎病毒（HBV）携带者的安全性和有效性。方法将2004年1月至2010年1月收治的32例B细胞NHL患者分为2组，A组（n=12）为感染HBV的患者，B组（n=20）为非感染HBV患者。A、B组均接受R-CHOP方案化疗4～6周期。A组化疗前应用拉米夫定抗病毒治疗1周。观察两组疗效、肝功能异常发生率。结果A组CR率为83.33%，B组CR率为85.00%（P＞0.05）。A组Ⅰ～Ⅱ级肝功能损害发生率为16.67%，B组15.00%（P＞0.05），两组差异无统计学意义。两组患者中均未发生HBV再激活。结论感染HBV的NHL患者用R-CHOP方案治疗及在化疗前预防性、足疗程的抗病毒治疗，可降低HBV再激活风险，减少肝功能损害。

ObjectiveTo study the efficacy and safety of rituximab combined with chemotherapy (R-CHOP regimen) in the treatment of non-Hodgkin′s lymphoma (NHL) patients complicated with HBV infection.Methods32 B-cell NHL patients were divided into two groups,group A (patients with HBV infection,n=12),and group B (patients without HBV infection,n=20).All of them were treated with R-CHOP regimen for four to six cycles from 2004 to 2010 and the group A was treated with lamivudine antiviral treatment before R-CHOP treatment.The duration of liver dysfunction and the efficacy of the treatment regimen were observed.ResultsThe complete response rate was 83.3% in group A,while 85.0% in group B (P＞0.05).Ⅰ-Ⅱ class live function impairment was 16.7% in group A,and 15.0% in group B (P＞0.05).Both two groups had not hepatitis B reactivation occurred.ConclusionNHL patients complicated with HBV infection,when treated with preventive anti-virus therapy before chemotherapy can decrease hepatitis B reactivation.

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