肝移植术后HBV再感染的危险因素分析及对策  

Risk factors and countermeasures for reinfection of hepatitis B virus after liver transplantation

作　　者：赵辉[1] 陆敏强[1] 蔡常洁[1] 杨扬[1] 陈规划[1] 

机构地区：[1]中山大学附属第三医院肝脏移植中心,中山大学器官移植研究所,广州市510630

出　　处：《消化外科》2006年第4期250-253,共4页Journal of Digestive Surgery

基　　金：广州市科技计划项目(2005Z3-E0101);广东省科技项目(2005B30501005);广东省自然科学基金(04009391)

摘　　要：目的探讨肝移植术后乙型肝炎病毒(HBV)再感染的危险因素及相关对策。方法对2003年9月至2004年12月间在我院施行原位肝移植术病例进行前瞻性研究,选取符合研究标准的130例患者,采用肌注型乙型肝炎免疫球蛋白(HBIg)联合核苷类抗病毒药物预防HBV再感染,并长期随访,分析HBV再感染的危险因素。结果130例中128例术后血清HBsAg转为阴性,并检测到HBsAb,平均随访12.2个月,HBV再感染率为6.3%(8/128)。结论肝移植术前血清HBeAg阳性、术后第1天血清HBsAg阳性及HBsAb<200U/L是HBV再感染的危险因素。Objective To probe into the risk factors and countermeasures for reinfection of hepatitis B virus （HBV） after liver transplantation. Methods A prospective study was done on 130 cases with HBV related late liver disease who underwent liver transplantation in our hospital from September 2003 to December 2004. All cases were given intramuscular injection ot hepatitis 15 immunoglobulin（HBIg） comblined with oral nucleoside analogs as prophylaxis for HBV reinfection and followed up for a long period to analyze the risk factors for HBV reinfection. Results Of all, 128 cases got negative HbsAg and detectable HbsAb, with mean follow-up period of 12. 2 months and HBV reinfection rate of 6.3% （8/128）. Conclusion Positive serum HBeAg before liver transplantation, positive HbsAg, and concentration of HBsAb less than 200 U/L at the first day after operation are risk factors for HBV reinfection.

关 键 词：肝移植 乙型肝炎 再感染 危险因素 

分 类 号：R657.3[医药卫生—外科学]