CAJ | 학술논문

目的分析血液疾病患者造血干细胞移植移(HSCT)植前供、受者HBsAg阳性对其造血干细胞移植的影响及综合抗病毒药物治疗的临床效果。方法对我院2001年12月~2012年12月间13例供/受者HBsAg阳性的造血干细胞移植的患者，进行移植前后乙肝免疫标记物、HBV-DNA、肝功能、血常规及骨髓象等检测，移植前后给予拉米夫定等药物进行综合抗病毒治疗，追踪观察3~6个月，结合临床资料进行综合分析。结果①HBsAg阳性对造血干细胞的植入时间无明显影响。②移植后部分患者有乙肝病毒再激活及相关的肝功能异常，但多可控制。③1例受者HBsAg阳性，移植后转阴。结论 HBsAg阳性增加了造血干细胞移植的难度和风险，但经过充分的综合抗病毒药物及保肝药物治疗，病毒复制及肝功能异常多可控制，所以供/受者HBsAg阳性不是造血干细胞移植的禁忌证。
목적분석혈액질병환자조혈간세포이식이(HSCT)식전공、수자HBsAg양성대기조혈간세포이식적영향급종합항병독약물치료적림상효과。방법대아원2001년12월~2012년12월간13례공/수자HBsAg양성적조혈간세포이식적환자，진행이식전후을간면역표기물、HBV-DNA、간공능、혈상규급골수상등검측，이식전후급여랍미부정등약물진행종합항병독치료，추종관찰3~6개월，결합림상자료진행종합분석。결과①HBsAg양성대조혈간세포적식입시간무명현영향。②이식후부분환자유을간병독재격활급상관적간공능이상，단다가공제。③1례수자HBsAg양성，이식후전음。결론 HBsAg양성증가료조혈간세포이식적난도화풍험，단경과충분적종합항병독약물급보간약물치료，병독복제급간공능이상다가공제，소이공/수자HBsAg양성불시조혈간세포이식적금기증。
Objective To analyze the impact of donors and recipients with HBsAg positive before the transplantation on the outcome of hematopoietic stem cel transplantation (HSCT) to patients with hematopathy and the clinical ef ect of synthetic antiviral therapy. Methods we conducted tests such as hepatic function, HBV immunological markers, HBV-DNA, routine blood test and myelogram etc for 13 HBsAg positive recipients or donors undergone hematopoietic stem cel transplantation (HSCT) in our hospital between December 2001 and December 2012, prescribed medication such as Lamivudine for synthetic antiviral therapy before and after the transplantation, conducted fol ow-up observation for 3-6 months, and analyzed comprehensively in combination with clinical data. Results ①HBsAg positive does not have a significant impact on the time of transplantation of hematopoietic stem cel . ②After the transplantation, the re-activation of hepatitis B virus and hepatic dysfunction are observed in some patients, but are mostly control able. ③One HBsAg positive recipient became HBsAg negative after the transplantation. Conclusion HBsAg positive increases the dif iculty and risk of hematopoietic stem cel transplantation (HSCT); however, after suf icient synthetic antiviral therapy and hepatoprotive medication therapy, HBsAg positive is not the contraindication of hematopoietic stem cel transplantation (HSCT).