拉米夫定及乙型肝炎免疫球蛋白预防肝移植后乙型肝炎复发的疗效观察

Effect of Lamivudine and Hepatitis B Immunoglobulin for Prevention of Recurrent Hepatitis B after Liver Transplantation.

目的:研究单用拉米夫定或与乙型肝炎(乙肝)免疫球蛋白(HBIG)联合应用对乙肝相关肝病病人肝移植术后预防乙肝复发的效果。方法:应用酶联免疫试验(EIA)检测HBsAg、抗鄄HBs、HBeAg、抗鄄HBe及抗鄄HBc;用聚合酶链反应法(PCR)检测乙肝病毒(HBV)DNA。26例单用拉米夫定15例,联合应用拉米夫定和HBIG11例。结果:26例乙肝相关肝病病人于肝移植术后随访3～24个月,2例死亡,4例出现乙肝复发,其余20例病人HBsAg持续阴性。结论:肝移植是治疗乙肝终末期病人的有效方法,拉米夫定与HBIG联合应用可有效预防肝移植术后乙肝复发。

Objective: To compare the effect of lamivudine alone or in combination with hepatitis B immunoglobulin (HBIG) for the prevention of hepatitis B recurrence after liver transplantation. Methods: HBsAg, anti-HBs, HBeAg, anti-HBe and anti-HBc were studied by enzyme-linked immunoassays(EIA), and hepatitis B virus(HBV) DNA by polymerase chain reaction(PCR). Results: Twenty-six patients with HBV-related liver diseases received liver transplantation and were given lamivudine alone or in combination with HBIG during or after the operation. All the patients were followed-up for 3～24 months. Among them, 2 died in 3 and 6 months after liver transplantation, and 4 had HBV recurrence, and the other 20 patients remaine HBsAg negative. Conclusions: Liver transplantation is a useful therapeutic mesure for patients with end-stage hepatitis B. Lamivudine in combination with HBIG is effective in the prevention of hepatitis B recurrence after liver transplantation.