阿德福韦酯联合乙肝免疫球蛋白预防HBV相关性终末期肝病肝移植术后复发的临床研究

目的：探讨阿德福韦酯（HDV）联合乙肝免疫球蛋白（HBIg）预防HBV相关性终末期肝病患者肝移植术后HBV复发的临床疗效。方法：回顾性分析2005年6月-2009年6月北京市解放军第302医院因HBV相关性终末期肝病接受肝移植的60例患者的临床资料。60例患者根据治疗方法分为治疗组和对照组，治疗组采用HDV联合HBk预防肝移植术后HBV复发，对照组采用拉米夫定（LAM）联合HBIg预防HBV复发。结果：两组患者随访期内未出现肾毒性表现。治疗组平均随访时间为（21．67±5．37）月，随访期内无复发。对照组平均随访时间为（21．83±6．02）月，随访期内有2例复发。两组术后复发率比较有显著性差异（P〈0．05）。结论：HDV联合HBIg预防肝移植术后HBV复发近期疗效优于LAM联合HBIg。

Effects of Adefovir Dipivoxil plus Hepatitis B Immunoglobulin in Prevention of HBV Recurrence in Patients with HBV-related End-stage Liver Disease aider Liver Transplantation

Objective： To investigate the effect of adefovir dipivoxil （ADV） combined with hepatitis B immunoglobulin （HBIg） therapeutics on prevention of hepatitis B virus （HBV） recurrence in patients with HBV-related end-stage liver disease alter liver transplantation （LT）. Methods： 60 cases with HBV-related end-stage liver disease of LT were chosen. 60 patients were divided into treatment group and control group according to different therapeutics. The patients of the treatment group was given ADV combined with HBIg therapeutics to prevent HBV recurrence, while the patients of the control group was given lamivudine（LAM） combined with HBIg therapeutics to prevent HBV recurrence. Results： The patients of the two groups were no renal toxicity during the follow-up time. The average follow-up time of the treatment group was （21.67 ± 5.37） months, there was no HBV recurrence during the follow-up time. The average follow-up time of the control group was （21.83 ± 6.02） months, there was 2 cases of HBV recurrence during the follow-up time. The HBV recurrence rate of the two groups was significantly different （P 〈0.05）. Conclusion： The ADV combined with HBIg therapeutics was better than LAM combined with HBIg therapeutics to prevent HBV recurrence in patients with HBV-related end-stage liver disease alter LT for the near term.