肝移植患者乙型肝炎病毒再感染的防治 |
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引用本文: | 郑树森,吴健,梁廷波,王伟林,黄东胜,马伟杭.肝移植患者乙型肝炎病毒再感染的防治[J].中华器官移植杂志,2000,21(6):366-368. |
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作者姓名: | 郑树森 吴健 梁廷波 王伟林 黄东胜 马伟杭 |
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作者单位: | 浙江大学医学院附属第一医院肝胆外科,杭州,310003 |
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摘 要: | 目的 预防和早期诊断肝移植患者术后乙型肝炎病毒(HBV)再感染和乙型肝炎(乙肝)的复发,以及探讨肝炎复发后的进一步治疗。方法 肝移植患者术后常规采用拉米夫定预防HBV再感染,同时监测肝功能、乙型肝炎血清标记物、血清HBV-DNA、肝活检组织乙型肝炎标记物免疫组化。结果 4例患者出现HBV再感染,其中2例表现为复发的乙型肝炎,经治疗后,2例复发的乙肝患者1例继续发展成为慢必 症肝炎,1例好转。结论
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关 键 词: | 肝移植 乙型肝炎病毒 复发 防治 |
Prevention and trealment of hepatitis B virus reinfection following liver transplantation |
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Abstract: | Objective To prevent and early diagnose hepatitis B virus(HBV) reinfection and recurrent hepatitis B following liver transplantation.and to discuss the further treatment of recurrent hepatitis B.Methods Patients undergoing liver transplantation received lamivudine to prevent HBV reinfection.Virological and biochemical data,serum HBV-DNA,and immunohistological staining for HBsAg and HBcAg in biopsy liver tissue were tested in due time.Results Of 4 cases diagnosed as having HBV reinfection,two presented hepatitis B recurrence after liver transplantation:One developed to chronic severe hepatitis B after great efforts of treatment and one improved after a series of treatment.Conclusions HBV reinfection or recurrent hepatitis B following liver transplantation occurred mostly about 6 to 12 months after operation.It should be considered hepatitis B recurrence when liver biochemistrical data became poor during this period.The treatment for recurrent hepatitis B after liver transplantation included increasing dosage of lamivudine.application of famciclovir,and other liver protective measures. |
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Keywords: | Liver transplantation Hepatitis B virus Recurrence |
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