乙型肝炎免疫球蛋白预防肾移植后新发乙型肝炎  

Effect of hepatitis B immunoglobulin to prevent de novo hepatitis B infection after renal transplantation

作　　者：李宁 武小桐 王明君 郭文萍 董塬 范钻 宁媛 刘婷婷 

机构地区：[1]山西省第二人民医院肾移植透析中心,太原030012

出　　处：《中华器官移植杂志》2012年第2期105-108,共4页Chinese Journal of Organ Transplantation

摘　　要：目的 探讨肾移植受者应用小剂量乙型肝炎免疫球蛋白（HBIG）预防术后新发乙型肝炎的安全性和有效性.方法 回顾性分析单中心2007年1月至2010年6月间肾移植受者的资料,将术前无乙型肝炎的138例受者作为试验组,术前肌肉注射小剂量HBIG,术后定期监测乙型肝炎表面抗体（HBsAb）滴度,根据其滴度调整术后应用HBIG的剂量,持续应用1年或1年以上.将2004年1月至2006年12月间术前无乙型肝炎的196例肾移植受者作为对照组,不采用乙型肝炎预防措施.观察两组移植后新发乙型肝炎的发病率,并记录急性排斥反应发生情况、受者和移植肾1年存活率.结果 随访12个月,试验组仅1例（0.7％）于术后6个月出现新发乙型肝炎,对照组11例（5.6％）出现新发乙型肝炎,其中2例因爆发性肝功能衰竭而死亡.两组新发乙型肝炎发病率的差异有统计学意义（P＜0.05）.术后6个月内,试验组有19例（13.8％）发生急性排斥反应,对照组有34例（17.3％）发生急性排斥反应,两组急性排斥反应发生率的差异无统计学意义（P＞0.05）.试验组受者1年存活率为97.8％（135/138）,移植肾1年存活率为（96.4％,133/138）;对照组受者1年存活率为（91.8％,180/196）,移植肾1年存活率为（90.3％,177/196）.两组受者和移植肾1年存活率的差异有统计学意义（P＜0.05.P＜0.05）.结论 小剂量HBIG用于肾移植后预防新发乙型肝炎是安全、有效的.Objective To summarize the safety and efficacy of low dose of hepatitis B immunoglobulin （HBIG） for prevention of de novo hepatitis B infection after renal transplantation.Methods The clinical data of 138 patients who received renal transplantation without hepatitis B infection between January 2007 and June 2010 were retrospectively studied （study group）.All the patients in study group were given low dose of HBIG injection before transplantation.The HBsAb titer was monitored regularly after transplantation,and the dosage of HBIG adjusted according to the level of the HBsAb titer.HBIG was implied to all patients in the study group for more than one year.The clinical data of 196 patients who received renal transplantation without hepatitis B infection between January 2004 and December 2006 served as the control group.These 196 patients were not treated with HBIG.The incidence of de novo hepatitis B infection,and acute rejection of these two groups was analyzed.The one-year graft and patients survival rate was also investigated.Results During the follow- up period of 12 months,only one case in the study group had de novo hepatitis B infection （0.7%） 6 months after renal transplantation,while 11 cases （5.6%） in the control group had de novo hepatitis B infection,in which 2 cases were died from acute hepatic failure.The incidence of de novo hepatitis B infection had statistically difference between the two groups （P〈0.05）.The incidence of acute rejection in the study and control groups was 13.8% and 17.3% respectively （P〉0.05）.The one-year graft and patient survival rate in the study and control groups was 96.4% and 97.8%,and 90.3% and 91.8% respectively （P〈0.05）.Conclusion Low dose of HBIG is effective and safe for prevention of de novo hepatitis B infection after renal transplantation.

关 键 词：肾移植 肝炎 乙型 免疫球蛋白类 预防 

分 类 号：R692[医药卫生—泌尿科学] R575.1[医药卫生—外科学]