CAJ | 학술논문

目的探讨乙肝相关肝移植受者接种乙肝疫苗的有效性.方法对肝移植术后健康生存2年以上的30例乙肝相关受者进行乙肝疫苗接种.采用0、1、2、3、6个月共5个免疫方案,每次皮下注射乙肝疫苗40 μg.以同期在门诊进行乙肝疫苗接种的30例健康人作为对照.初次接种疫苗后第1、2、3、6、9、12个月检测乙肝表面抗体(Anti-HBs)滴度.结果 30例肝移植受者中,6.7％ (2/30)接种成功(初次接种12个月后Anti-HBs＞ 100 IU/L),16.7％ (5/30)产生部分应答(3例Anti-HBs滴度升高不足100 IU/L,2例接种过程中Anti-HBs滴度超过100 IU/L,之后逐渐降低,12个月后低于100 IU/L).原发病为急性肝衰竭的9例受者中有22.2％ (2/9)接种成功,另有22.2％ (2/9)出现部分应答;肝移植术后超过5年的9例受者中有22.2％ (2/9)接种成功,另有11.1％ (1/9)出现部分应答.健康对照组中有73.3％(22/30)接种成功,另有10％(3/30)产生部分应答.结论部分肝移植受者可以通过乙肝疫苗主动免疫来预防乙肝复发;乙肝相关肝移植受者乙肝疫苗接种的成功率低于健康人;急性肝衰竭和移植术后超过5年的受者乙肝疫苗接种的应答率较高.乙肝疫苗接种可以作为一种预防移植术后乙肝复发的方法.
목적 탐토을간상관간이식수자접충을간역묘적유효성.방법 대간이식술후건강생존2년이상적30례을간상관수자진행을간역묘접충.채용0、1、2、3、6개월공5개면역방안,매차피하주사을간역묘40 μg.이동기재문진진행을간역묘접충적30례건강인작위대조.초차접충역묘후제1、2、3、6、9、12개월검측을간표면항체(Anti-HBs)적도.결과 30례간이식수자중,6.7％ (2/30)접충성공(초차접충12개월후Anti-HBs＞ 100 IU/L),16.7％ (5/30)산생부분응답(3례Anti-HBs적도승고불족100 IU/L,2례접충과정중Anti-HBs적도초과100 IU/L,지후축점강저,12개월후저우100 IU/L).원발병위급성간쇠갈적9례수자중유22.2％ (2/9)접충성공,령유22.2％ (2/9)출현부분응답;간이식술후초과5년적9례수자중유22.2％ (2/9)접충성공,령유11.1％ (1/9)출현부분응답.건강대조조중유73.3％(22/30)접충성공,령유10％(3/30)산생부분응답.결론 부분간이식수자가이통과을간역묘주동면역래예방을간복발;을간상관간이식수자을간역묘접충적성공솔저우건강인;급성간쇠갈화이식술후초과5년적수자을간역묘접충적응답솔교고.을간역묘접충가이작위일충예방이식술후을간복발적방법.
Objective To investigate the efficacy of hepatitis B vaccination in preventing hepatitis B (HBV) recurrence after liver transplantation for hepatitis B virus-related (HBV-related) recipients.Methods 30 healthy recipients who survived for more than 2 years after liver transplantation received vaccination using hepatitis B surface antigen (HBsAg)-containing vaccine.There were a total of 5 injections at 0 month, 1 month, 2 months, 3 months and 6 months respectively, and each dose was 40 μg.Thirty healthy adults who received hepatitis B vaccination during the same period were selected into the control group.The antibody of hepatitis B surface (Anti-HBs) titer was tested at 1 month, 2 months, 3 months, 6 months, 9 months and 12 months after the first vaccination.Results 6.7％ (2/30) of the liver transplantation recipients had good response (defined as a rise of Anti-HBs titer of more than 100 IU/L at 12 months after the primary vaccination), and 16.7％ of recipients (5/30) had partial response (Anti-HBs titer in 3 patients at less than 100 IU/L, Anti-HBs titer in 2 patients at more than 100 IU/L at first, then less than 100 IU/L after 12 months).For the 9 patients who received liver transplantation for acute liver failure, 2 had good response (22.2％) and another 2 patients (22.2％) had partial response.For the liver transplant recipients who survived for more than 5 years, 2 had good response (22.2％) and another patient (11.1％) had partial response.In the healthy control group, the good response rate was 73.3％ (22/30), and the partial response rate was 10％ (3/30).Conclusions Some HBV-related liver transplant recipients could acquire Anti-HBs by vaccination.Good response rate was lower in the HBV-related group of liver transplant recipients than in the healthy control group of people.Recipients for liver transplantation carried out for acute liver failure and recipients who survived for more than 5 years had higher response rates to HBV vaccination.HBV vaccination can be a way to prevent HBV recurrence in some liver transplant recipients.