乙、丙型肝炎病毒感染对肾移植患者长期存活的影响

目的　了解乙型肝炎病毒（ＨＢＶ） 及丙型肝炎病毒（ＨＣＶ） 感染对肾移植患者长期存活的影响。方法　对８０ 例感染ＨＢＶ、ＨＣＶ 者肾移植术后肝病及排斥的发生情况、死亡原因及长期存活率进行分析。结果　移植后慢性肝病发生率为２１ ．２５％ ， 死亡率为１８ ．７５ ％ ， 显著高于非感染组（１ ．１９ ％ ， Ｐ＜ ０．０１） ；ＨＣＶ 组超急性排斥及加速性排斥的发生率（６ ．０６％ ，９ ．０９ ％ ） 显著高于非感染组（０ ．７２ ％ ，２ ．７４ ％ ； Ｐ＜ ０ ．０１ ， Ｐ＜ ０ ．０５）。结论　ＨＢＶ及ＨＣＶ感染显著影响肾移植受者的长期存活率； 移植后肝病及感染是其主要死因； 对ＨＢＶ 及ＨＣＶ 感染患者应采取合理的免疫抑制治疗。

The influence of infection of hepatitis B and hepatitis C virus on the long-term survival of the renal transplantation recipients

Objective To investigate the impact of infection of hepatitis B and hepatitis C virus on the long term survival of renal transplantation recipients. Methods Post transplantation liver diseases, graft rejection, mortality and long term survival rate were postoperatively studied in 80 recipients infected with hepatitis B or hepatitis C virus in 499 renal transplantation recipients. Results In 80 renal transplant patients infected with HBV or HCV, 17 cases developed posttransplantation liver diseases ( 21.25% ), 8 cases died from liver failure and 4 cases died from septicemia. The mortality of the 80 cases ( 18.75% ) was significantly higher than in the non infection ones ( 1.19% , P < 0.01 ). In 33 HCV infection patients 2 cases were diagnosed having hyperacute rejection ( 6.06% ) and 3 cases accelerated rejection ( 9.09% ), significantly higher than in HCV non infection patients ( 0.72% and 2.74% respectively, P < 0.01 and P < 0.05 ). Conclusions HBV and HCV infection could significantly lower the survival of renal transplantation patients. The major causes for death were liver diseases and infection following transplantation. Reasonable immunosuppression therapy was given to the HBV or HCV infection patients.