肝移植术后乙型肝炎病毒再感染的防治
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杨广顺

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Prevention and treatment of hepatitis B virus reinfection after orthotopic Iiver transplantation
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    摘要:

    目的:探讨肝移植术后乙型肝炎病毒(HBV)再感染的预防策略及效果。
    方法:对120例乙型肝炎相关患者接受原位肝移植术后,使用肌内注射乙型肝炎免疫球蛋白(HBIg)联合拉米夫定或阿德福韦等治疗HBV再感染患者的临床资料进行回顾性总结。
    结果:经23~59个月随访,全组4例出现HBV再感染,再感染率为3.3%。4例经治疗后经随访19~26个月,均出现HBV-DNA转阴,但未见HBsAg转阴。
    结论:小剂量HBIg联合拉米夫定或阿德福韦可有效预防肝移植术后HBV的再感染;术前HBV-DNA负荷量与术后HBV再感染可能有关。

    Abstract:

    Abstract:Objective:To investigate the strategy and outcome of prevention of hepatitis B virus(HBV) reinfection after orthotopic liver transplantation (OLT).
    Methods :A total of 120 patients with chronic fulminant hepatitis B,end-stage of liver cirrhosis and liver carcinoma were given hepatitis B immunoglobulin (HBIG) plus lamivudine or adefovir after OLT to prevent HBV reinfection.The serum HBV and HBV DNA were determined and clinical observation were performed.
    Results:Follow-up time ranged from 23-59 (median 45.2) months. Four patients had reinfection with positivity of HBsAg,HBeAb and HBcAb, the serum HBV DNA was also positive.All 4 patients became HBV-DNA negative after treatment and folloed-up for 19-26 months, but HBsAg remained positive.
    Conclusions:HBIG plus lamivudine or adefovir can effectively prevent HBV reinfection after OLT. Load level of HBV-DNA before OLT was related with HBV reinfection after operation.

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张海斌,李团结,杨宁,朱楠,司马辉,卢军华,杨广顺.肝移植术后乙型肝炎病毒再感染的防治[J].中国普通外科杂志,2008,17(7):2-635.
DOI:10.7659/j. issn.1005-6947.2008.07.002

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  • 在线发布日期: 2008-07-25