CAJ | 학술논문

目的总结肝移植术后预防乙型肝炎复发的临床经验,探讨预防乙肝病毒再感染的个体化治疗措施.方法回顾性分析我院2004年7月至2008年6月完成的195例乙肝相关性终末期肝病患者的肝移植临床资料,按照其移植术后抗病毒方案不同分为两组:A组(168例)应用拉米夫定(LAM)联合乙肝免疫球蛋白(HBIG);B组(27例)应用阿德福韦(ADF)联合乙肝免疫球蛋白.平均随访(23.7±13.4)月,观察总体及两组复发率.结果 A组和B组各复发1例,复发时间分别在术后6个月至11个月,复发率分别为0.6%(1/168)和3.7%(1/27),总体复发率为1%,两组复发率差异无统计学意义(P=0.14).结论拉米夫定联合HBIG可有效预防肝移植术后乙型肝炎复发,根据术前病毒携带情况调整抗病毒方案与HBIG用量可获得满意疗效.
목적 총결간이식술후예방을형간염복발적림상경험,탐토예방을간병독재감염적개체화치료조시.방법 회고성분석아원2004년7월지2008년6월완성적195례을간상관성종말기간병환자적간이식림상자료,안조기이식술후항병독방안불동분위량조:A조(168례)응용랍미부정(LAM)연합을간면역구단백(HBIG);B조(27례)응용아덕복위(ADF)연합을간면역구단백.평균수방(23.7±13.4)월,관찰총체급량조복발솔.결과 A조화B조각복발1례,복발시간분별재술후6개월지11개월,복발솔분별위0.6%(1/168)화3.7%(1/27),총체복발솔위1%,량조복발솔차이무통계학의의(P=0.14).결론 랍미부정연합HBIG가유효예방간이식술후을형간염복발,근거술전병독휴대정황조정항병독방안여HBIG용량가획득만의료효.
Objective To summarize the clinical data in preventing HBV recurrence after liver transplantation and explore a optimal individual protocol in prophylaxis of HBV recurrence. Methods We retrospected outcomes in 195 recipients who underwent a liver transplantation for HBV-related liver disease between June 2004 and July 2008. According to the anti-virus protocol these recipients are divided into two groups as following: group A received a protocol of combination treatment of lamivudine with HBIG, and group B with combination treatment of adefovir with HBIG. With mean follow-up of 23.7 months, HBV recurrent rate was observed in overall and each group separately. Results A total of 195 liver transplant recipients were identified that met the study criteria. At the sixth and eleventh month after operation, HBV recurrence appeared in 2 recipients, each in two groups, which were due to LAM cessation and HBV mutation respectively. Recurrent rate was 0.6% in group A, 3.7% in group B and 1% in total. There was no significant difference in HBV recurrent rate between group A and B. Conclusion Lamivudine combined with HBIg should be considered as a reliable method in preventing HBV recurrence after liver transplantation. Better outcomes can be achieved by individual anti-virus protocol and HBIg administration according to HBV stares in recipient.