182例肝移植病人术后19个月乙肝复发的临床随访观察

目的 肝移植病人术后乙肝复发的临床随访观察.方法 复诊与随访表调查.结果 拉米呋啶和HBIG联用的情况下,8个分中心的182例肝移植病人术后19个月随访期的乙肝复发率为0.55%.若将术后1周内230个研究病例中血清HBsAg未阴转的9个病例(3.91%)视为乙肝复发病例,术后19个月试验与对照组复发率分别为6.89%(6/87),4.21(4/95).采用循证医学方法,分析世界范围内单用HBIG、拉米呋啶及拉米呋啶和HBIG联用3种方法,认为均有不同程度防治肝移植病人术后乙肝复发的效果.结论 该次临床随访时间与多数的历史文献对照观察时间点形成重叠,临床研究与随访的乙肝复发率与既往文献结果吻合,拉米呋啶和HBIG联用是较优的防治策略.

Clinical follow-up investigation of hepatitis B recurrence for 19 months after liver transplantation in 182 patients

Objective To follow up the hepatitis B recurrence after liver transplantation. Meth-ods Further consultation with doctors and clinical follow-up investigation were conducted. Results After treatment with the lamivudine in combination with hepatitis B immunoglobulin (HBIG) prophy-laxis for 19 months after liver transplanation, 182 patients in 8 medical centers had a hepatitis B re-currence rate of 0.55 %. If we regarded 9 patients of 230 study cases (3.91%) with serum HBsAg se-ropositivity during the course of 1 week after liver transplantation to be the hepatitis B recurrence ca-ses, hepatitis B recurrence rate of the trial and control group was 6.89%(6/87) and 4.21(4/95), re-spectively. Depending on worldwide bibliographic database analysis, it is generally believed that using lamivudine or HBIG alone, using ]amivudine in combination with HBIG, or using all 3 Method have prophylaxis effectiveness to hepatitis B recurrence after liver transplantation, which differ only in de-gree. Conclusion The time of follow-up investigation overlaps with majority document published.The hepatitis B recurrence rate of clinical study and follow-up investigation are similar with Results of document published. Lamivudine in combination with HBIG is better than using lamivudine or HBIG alone.