术前服用拉米夫定时间与肝移植术后HBV复发的关系  

Relationship between the Time of Oral Administration of Lamivudine Before Liver Transplantation and Hepatitis B Recurrence after Liver Transplantation

作　　者：郑俊福[1] 

机构地区：[1]首都医科大学附属北京佑安医院,北京100077

出　　处：《中国现代医生》2009年第27期16-18,F0003,共4页China Modern Doctor

摘　　要：目的评价术前服用拉米夫定时间的长短对于预防原位肝移植（OLT）术后HBV复发的效果，探讨术前服用拉米夫定的适宜时间。方法回顾性分析从2003年7月-2008年2月行同种异体原位肝移植术患者，根据术前服用拉米夫定时间的长短分为三组，短期组服用时间小于1个月，中期组服用1个月至6个月，长期组服用大于6个月；比较术前短期、中期或长期服用拉米夫定对预防HBV复发的效果；三组患者观察截止到2008年11月，对三组患者中不同的HBV复发率进行统计学分析。结果三组患者随访时间平均（18±2．17）个月，短期组在观察期内发现乙肝病毒复发8例；复发率13．7％（8／58），中期组在观察期内未发现乙肝病毒复发；长期组在观察期内发现乙肝病毒复发2例，复发率10．5％（2／19）；总复发率9．4％（10／106）。中期组复发率低于短期组及长期组，短期组与中期组两组差异有统计学意义。结论术前服用拉米夫定1个月至6个月能有效地预防术后乙肝复发，过短及过长服用拉米夫定均增加术后乙肝复发机率。Objective To investigate whether the time patients took lamivudine orally before transplantation has an effect on prophylaxis of the HBV recurrence after orthotopic liver transplantafion（OLT） in an effort to find the appropriate time of oral administration of lamivudine before liver transplantation. Methods Between July 2003 and Feb. 2008,106 cases of orthotopic liver transplantation were divide into three groups. The short term group：the time of oral administration of lamivudine before transplantation was less than 1 month, the intermediate term group： the time of oral administration of lamivudine before transplantation was from 1 month to 6 months and the long term group： oral administration of lamivudine before transplantation was more than 6 months. The HBV recurrence rate in the three groups was compared. The three groups were fellowed up to Nov.2008.The HBV recurrence rate was analyzed in three groups. Results Three groups were fellowed up in average period of（ 19.5 ± 9.4）months. The recurrence was found in 8 cases of the short term group,with the HBV recurrence rate being 13.7%. No recurrence case was in the intermediate term group. The recurrence was found in 2 cases of the long term group,with the HBV recurrence rate being 10.5%（2/19）. The HBV recurrence rate of the intermediate term group was lower than that of the short term group and long term group. The rate between the short term group and intermediate term group has statistical difference（P〈 0.05）. Conclusion The appropriate time of oral administration of lamivudine before liver transplantation in the effective prevention of HBV recurrence is 1 month to 6 months, and shorter or longer than this period will increase the HBV recurrence rate.

关 键 词：肝移植 乙型肝炎病毒 拉米夫定 复发 

分 类 号：R657.3[医药卫生—外科学]