肾移植术后合并重型肝炎临床探讨

Clinical exploration of etiology,treatment and prevention of severe hepatitis after kidney transplantation

目的:探讨肾移植术后重型肝炎病因、治疗及预防。方法:对330例肾移植患者所发生的8例肾移植术后重型肝炎患者的临床资料进行分析。结果:6例患者为慢性重型肝炎,2例患者为急性重型肝炎。病毒学检测均有乙肝病毒感染且病毒处于复制状态,8例均于移植术前感染,经积极治疗后,6例患者死亡,好转2例。结论:重型肝炎是肾移植术后严重的并发症之一,主要病因为乙型肝炎病毒及免疫抑制剂的毒性,术后密切监测肝功能及环孢素A(CsA)浓度、HBVDNA的滴度,早期发现、早期治疗,加强预防。

Objective:To study the etiology,treatment and prevention of severe hepatitis after kidney transplantation.Methods:A retrospecˉtive analysis was made on8severe hepatitis cases among330patients following kidney transplantation.Results:The6patients were diagnosised with chronic severe hepatitis,2patients were diagnosised with acute severe hepatitis.8patients had infected HBV before kidney transplantation,6cases died,2cases were out,the mortality rate was75%.Conclusion:Post-kidney transplantation severe hepatitis is one of the severe compliˉcations.The major etiology is hepatitis virus and immunosuppressant.Monitoring liver function,CsA concentration and HBV-DNA concentration,eary detection,early treatment and strengthening prevention would improve the survival rate.