Abstract: Background　Due to the high prevalence of primary bronchogenic carcinoma （lung cancer） and hepatitis B virus infection in China，lung cancer patients infected with HBV are common.Some studies found that lung cancer patients who infected with HBV have higher rates of liver damage and hepatitis B virus reactivation（HBVR）than those without HBV.Objective　To investigate the effect of prophylactic antiviral therapy on hepatic impairment and hepatitis B virus reactivation（HBVR） in lung cancer patients with hepatitis B virus surface antigen（HBsAg） infection.Methods　According to the inclusion and exclusion criteria，from Changhai Hospital during 2015 to 2017，we enrolled 61 lung cancer inpatients with positive HBsAg test result（HBsAg-positive group），including 29 who received prophylactic antiviral therapy（intervention subgroup） and 32 who did not（control subgroup），and other 61 lung caner inpatients without HBsAg infection（HBsAg-negative group）．The incidence of hepatic impairment was compared between the intervention subgroup，control subgroup and HBsAg-negative group.And the incidence of HBVR was compared between the intervention subgroup and the control subgroup.Results　The incidence of hepatic impairment in the control subgroup was higher than that in the HBsAg-negative group at the first third hospitalization（P<0.05）．At the first hospitalization，the incidence of hepatic impairment in the HBsAg-negative group was lower than that in the intervention subgroup（P<0.05）．At the first third and fifth hospitalizations，there was no significant difference in the incidence of hepatic impairment between the intervention subgroup and  the control subgroup（P>0.05）．There was no significant difference in the incidence of HBVR between the intervention subgroup and the control subgroup（P>0.05）．Conclusion　HBV infection can significantly increase the risk of hepatic impairment in lung cancer patients during antitumor therapy.But the absolute risk of hepatic impairment in this population during antitumor therapy can be reduced by prophylactic antiviral therapy．

Key words: Lung neoplasms, Hepatitis B virus, Hepatic insufficiency, Antivirus therapy

摘要： 背景　肺癌和乙型肝炎病毒（HBV）感染在我国均具有高流行率，合并HBV感染的肺癌患者在我国较为常见。有研究发现该类患者在抗肿瘤过程中存在较高的肝功能损伤及HBV再激活的风险。目的　探讨预防性抗病毒治疗对乙肝表面抗原（HBsAg）阳性肺癌患者肝功能损伤及HBV再激活的影响。方法　收集2015—2017年于上海长海医院住院治疗的符合纳入标准的HBsAg阳性肺癌患者61例（HBsAg阳性组），其中预防性抗病毒29例（干预亚组），未预防性抗病毒32例（对照亚组）。并收集同期住院未合并HBV感染的肺癌患者61例（HBsAg阴性组）。比较干预亚组、对照亚组与HBsAg阴性组患者肝功能损伤发生率，干预亚组与对照亚组患者HBV再激活发生率。结果　第1、3次住院时对照亚组患者肝功能损伤发生率高于HBsAg阴性组（P<0.05）。第1次住院时HBsAg阴性组患者肝功能损伤发生率低于干预亚组（P<0.05）。第１、3、5次住院时干预亚组患者肝功能损伤发生率与对照亚组比较，差异无统计学意义（P>0.05）。干预亚组、对照亚组患者HBV再激活发生率比较，差异无统计学意义（P>0.05）。结论　HBV感染可造成肺癌患者抗肿瘤治疗期间肝功能损伤的发生率升高。给予HBsAg阳性肺癌患者预防性抗病毒治疗，可降低抗肿瘤治疗期间肝功能损伤的绝对风险。

关键词: 肺肿瘤, 乙型肝炎病毒, 肝功能不全, 抗病毒治疗