肝移植术后乙肝复发的预防与处理  

PROPHYLACTIC STRATEGIES AND TREATMENT OF HEPATITIS B VIRUS RECURRENCE AFTER LIVER TRANSPLANTATION

作　　者：奚志峰[1] 夏强[1] 张建军[1] 陈小松[1] 张明[1] 李齐根[1] 徐宁[1] 薛峰[1] 宋玉[1] 韩龙志[1] 王鑫[1] 沈丛欢[1] 罗毅[1] 邢天宇[1] 

机构地区：[1]上海交通大学医学院附属仁济医院,上海200127

出　　处：《肝胆外科杂志》2007年第5期350-354,共5页Journal of Hepatobiliary Surgery

摘　　要：目的总结和探讨肝移植术后乙肝复发的预防与处理。方法回顾性分析253例乙肝相关性肝病行肝移植术患者乙肝防治方法、术后乙肝复发的处理。结果术后乙肝复发者7例,复发率2.76%。复发后分别采用加大乙肝免疫球蛋白(HB IG)剂量、改用恩替卡韦、加用贺维力等措施,2例HBsAg经治疗后转阴,2例HBsAg明显下降,总有效率57%。结论肝移植术后HB IG+拉米夫丁能有效预防肝移植术后乙肝复发,HB IG、恩替卡韦、贺维力能不同程度控制肝移植术后乙肝复发。Objective To study the prevention and treatment of hepatitis B virus recurrence after liver transplantation. Methods Retrospectively analyze the prophylactic strategies and hepatitis B recurrent ratio after liver transplantion. Otherwise to analyze the management of hepatitis B recurrence. Result There are 7 patients diagnosed as hepatitis B recurrence after liver transplantation in 253 patients. HBIG and entecavir and adefovir were used to treat these patients. 2 patients became HbsAg undetectable and HbsAg decreased significantly of 2 patients. The efficiency is 57%. Conclusion HBIG together with lamivudine can prevent hepatitis B re-currence after liver transplantation. HBIG, entecavir or adefovir can be a good choice for the treatment of hepatitis B recurrence.

关 键 词：乙肝复发 肝移植 HBIG 恩替卡韦 贺维力 

分 类 号：R575[医药卫生—消化系统]