小剂量乙型肝炎免疫球蛋白与拉米夫定联合使用对肝移植术后乙肝复发的疗效

目的　探讨有效的预防乙肝相关性终末期肝病肝移植术后乙肝复发的有效方法。方法　对 3 4例肝移植后患者进行分组 ,单纯使用拉米夫定组 16例 ;小剂量HBIG与拉米夫定联合使用组 18例 ,全部得到随访。结果　单纯组随访 6～ 3 2月 ,平均 18 1月 ,有 4例术后乙肝复发 ,已死亡 3例 ;联合组随访 3～ 2 0月 ,平均 15 1月 ,仅 1例术后 3月出现HBsAg阳性 ,经积极治疗 4月重新转阴性 ,现已术后 12月 ,肝功能正常。结论　小剂量HBIG与拉米夫定联合使用对乙肝相关终末期肝病肝移植术后乙肝复发有良好的效果 ,单纯使用拉米夫定仍有较高的复发率且有YMDD变异的危险。

INTRAMUSCLAR LOW-DOSE HEPATITIS B IMMUNE GLOBULIN COMBINED WITH LAMIVUDINE FOR PROPHYLAXIS AGAINST HEPATITIS B RECURRENCE AFTER LIVERTRANSPLANTATION

Objective: To study the efficiency of liver transplantation on the end-stage hepatitis B related liver diseases, the prevention and the treatment of hepatitis B recurrence after the liver transplantation. Methods: The efficiency of 34 patients having received the liver transplantation was retrospectively studied, 16 patients of whom in one group treated with lamivudine alone, and the other 18 of whom in the second group with the combination therapy of low-dose HBIG and lamivudine. Results: While 4 patients in group 1 became hepatitis B recurrence after the liver transplantation, only one patient in group 2 became HBsAg positive again soon after the liver transplantation. Conclusions: Liver transplantation is an effective therapy for the end-stage hepatitis B related liver diseases. Combination treatment of low-dose in group 2 HBIG and lamivudine may prevent recurrence of hepatitis B after the liver transplantation.