Analysis Of The Effect Of Antiviral Intervention On Liver Function Of Lung Cancer Patients With Hepatitis B Virus Carriers After Chemotherapy

Objective:To explore the clinical effect of preventive antiviral on liver damage for lung cancer patients with Hepatitis B Virus carriers after chemotherapy.To search for effective drugs to prevent and treat liver damage after chemotherapy in lung cancer patients with hepatitis B virus carriers.To provide valuable clinical trial data for preventing chemotherapy delayed or terminated and improving prognosis.Methods:80 patients who were admitted to Laiwu People's Hospital,diagnosed with lung cancer by pathology or cytology,and complicated with hepatitis B virus were selected as the research subjects.They were divided into observation group and control group according to different treatment methods.There were 40 cases in each group.Patients in the observation group started to take entecavir 0.5 mg orally 7 days before conventional chemotherapy,once a day,until 4 weeks after the end of chemotherapy.Patients in the control group were not given antiviral therapy before conventional chemotherapy,but had abnormal liver function or hepatitis B virus.After reactivation,entecavir and hepatoprotective drugs were given.The changes in the incidence of hepatitis B virus reactivation,the degree of liver function impairment,the delay or interruption of chemotherapy,and the toxicity of chemotherapy after two cycles of chemotherapy were compared between the two groups of patients.Results:There was no significant difference in serum ALT,AST and TBIL levels between the observation group and the control group before chemotherapy(t = 0.16 ~ 0.56,P>0.05).After 2 and 4 cycles of chemotherapy,the serum ALT,AST,and TBIL levels in the observation group and the control group were significantly higher than those of ALT,AST,and TBIL levels before chemotherapy(F = 2.64 ~ 15.27,P <0.05),while the observation group Serum levels of ALT,AST and TBIL were significantly lower than those in the control group(t = 2.14-5.31,P <0.05).There were 2 patients with hepatitis B virus reactivation in the observation group(5.0%),and those in the control group There were 8 patients with hepatitis B virus reactivation(20.0%).The incidence of hepatitis B virus reactivation in the observation group was significantly lower than that in the control group(?2 = 4.200,P<0.05).Hepatitis B virus reactivation is related to HBV-DNA load.When HBV-DNA ?105copis / ml,HBV reactivation is prone to occur,regardless of the patient's gender,lung cancer pathological type,and clinical stage.In the observation group,there were 3 patients with delayed or interrupted chemotherapy due to abnormal liver function of grades III and IV(8.6%),and delayed or interrupted chemotherapy due to abnormal liver function of grades III and IV in the control group.There were 9 patients(25.7%).The incidence of delayed or interrupted chemotherapy in the observation group was significantly lower than that in the control group(?2 = 3.621,P <0.05).The main toxicities of chemotherapy in the two groups of patients were bone marrow suppression,nausea,vomiting,fatigue,etc.,most of them were grade 2 or less,and they returned to normal after symptomatic supportive treatment.Conclusion:Entecavir may reduce liver damage after chemotherapy in lung cancer patients with Hepatitis B Virus carriers.It is necessary to use entecavir therapy while the lung cancer combined with hepatitis B virus carriers receive chemotherapy.