拉米夫定联合乙肝免疫球蛋白阻断肝移植后HBV再感染的荟萃分析  

Combined lamivudine and hepatitis B immunoglobulin to prevent hepatitis B recurrence after liver transplantation:a Meta-analysis study

作　　者：魏立青[1] 张耀[2] 宫海燕[3] 

机构地区：[1]第三军医大学干休所 [2]第三军医大学军事预防医学院军队流行病学教研室 [3]第三军医大学西南医院预防感染控制科,重庆400038

出　　处：《第三军医大学学报》2009年第10期981-983,共3页Journal of Third Military Medical University

摘　　要：目的系统评价拉米夫定与乙肝免疫球蛋白联合应用阻断肝移植后HBV再感染的疗效。方法应用Meta分析的方法比较治疗组(联合应用LAM和HBIG)与对照组(单一应用LAM或HBIG)对移植后HBV再感染率的差异,以比值比(OR)为效应量进行合并分析。结果共纳入研究文献7篇,研究样本360例。OR及95%可信限(95%CI)为0.34(95%CI:0.18,0.64),2组间HBV复发率的差异具有统计学意义(Z=3.33,P=0.001)。各研究之间具有同质性(P=0.310)。结论拉米夫定与乙肝免疫球蛋白联合应用可有效阻断肝移植后HBV再感染,且联合用药的效果优于单一用药。Objective To evaluate the efficiency of lamivudine combined with hepatitis B immunoglobulin to prevent hepatitis B recurrence after liver transplantation. Methods The literature concerning the application of lamivudine and hepatitis B immunoglobulin after liver transplantation was collected. The efficacy of initial lamivudine, and hepatitis B immunoglobulin alone or combined together was evaluated in liver transplantation recipients with hepatitis B by performing a systematic review of the literature with a Meta-analysis of clinical trials. Odds ratio （OR） was applied to evaluate the effect of therapeutic alliance to decrease the reinfection rate whether or not. Results We identified 7 clinical trials, and there were 360 patients subjected. OR and 95% confidence interval （95% CI） was 0.34 （95% CI ranging from 0.18 to O. 64）. For overall test result, Z value was 3.33 and P value was 0.01. The P value was O. 310 for our test of study homogeneity. Conclusion Our meta-analysis shows that lamivudine or hepatis B immunoglobulin can effective prevent hepatitis B recurrence after liver transplantation, and therapeutic alliance is more effective than monotherapy, and tolerance to lamivudine or hepatis B immunoglobulin was good.

关 键 词：肝移植 再感染 Meta分析 

分 类 号：R181.32[医药卫生—流行病学] R512.620.1[医药卫生—公共卫生与预防医学]