乙肝免疫球蛋白预防肝移植后乙肝复发

Application of Hepatitis B Immunoglobulin in Prevention of Hepatitis B Recurrence after Liver Transplantation

目的探讨肝移植术后乙肝复发的预防方法,提高乙肝相关疾病患者肝移植的疗效。方法对120例成人乙肝患者肝移植的临床资料进行回顾性研究,比较小剂量HBIG+Lamivudine与单纯应用Lamivudine预防肝移植术后乙肝复发的区别。结果Lamivudine组75例患者,12例患者发现有肝炎复发,复发率为16.7%(12/75),其中4例检测到YMDD变异株。联合用药组45例患者有3例乙肝复发,复发率为6.7%(3/45),未检测到YMDD变异株。结论小剂量HBIG+Lamivudine比单纯使用Lamivudine能更有效预防肝移植术后乙肝复发,且术后发生YMDD变异的危险性降低。

Objective To explore the strategy for prevention of HBV recurrence and improve the long-time survival after liver transplantation. Methods The data of 120 adult patients underwent liver transplantation in Organ Transplantation Center, the First Affiliated Hospital of Sun Yat-sen University, were retrospectively reviewed. The recipients were divided into Lamivudine monotherapy gourp （n=75） and Lamivudine＋low dose HBIG （hepatitis B immunoglobulin） group （n=45）. Comparison between these two groups was made. Results In launivudine group, 12 recipients had HBV recurrence （16.7%）, four of them had tyresine - methionine - aspartate - aspartate （YMDD） mutation. In Lamivudine ＋ HBIG group, 3 recipients had HBV recurrence （6.7%）. YMDD mutation was not detected. Conclusion Low dose of HBIG plus lamivudine therapy may be used to reduce the incidence rate of YMDD.