肝炎病毒感染对肾移植患者肝损害的临床观察

The clinical observation of the liver damage in hepatic virus carriers after renal transplantation

分析肝炎病毒感染对肾移植术后肝损害的影响 ,以探讨治疗病毒性肝损害的可行办法。将 4 2例肝炎病毒感染者作为阳性组 ,同期无病毒感染者 14 4例为阴性组。术后采用相同的三联免疫抑制方案 (Pred +MMF +CsA) ,同时监测肝功能、HBV -DNA、HCV -RNA及CsA药物浓度 ,对肝功异常者停用CsA改用FK5 0 6 ,并行保肝治疗 ,HBV -DNA(+)者还加用拉米夫定。结果显示 :不同肝炎病毒感染者术后药物性肝损害发病率均高于无病毒感染者 ,若术前肝功异常 ,术后肝损害发病率更高、损害更重。因此 ,对有肝炎病毒感染的肾移植患者更应警惕术后肝损害的发生。

To analyze the influence of hepatic virus infection on renal allograft recipients. The 42 patients infected hepatitis virus (positive group) and 144 patients without infection (negative group) were treated with similar immunosuppressive agents and liver protection medicine, lamivudine were added to those HBV-DNA positive. Moreover, liver function?viral sign and medical concentration were periodically tested. The result showed that the incidence rate of medical liver damage lead by different hepatitis virus infection were significantly higher than those without it. If liver dysfunction exist before operation, the incidence rate and the degree of liver damage were higher and severer. This suggested that the incidence of liver damage in those renal recipients infected HBV should be advocated to be on guard.