摘要
目的研究乙型肝炎相关性肝病肝移植术后急性排斥反应的发病率、治疗和预防。方法前瞻性地研究用肝移植术治疗乙型肝炎相关性肝病100例,分析急性排斥反应的发病相关因素,急性排斥反应和免疫抑制剂治疗的动态监测及二者间的联系。结果临床型急性排斥反应的发病率为12%,急性排斥反应发生前3～5d,有明显的免疫抑制剂浓度降低的过程。FK506为基础的免疫抑制方案,加用骁悉,可有效地终止、逆转急性排斥反应;和以甲基强的松龙冲击治疗急性排斥反应相比较,副作用少,但肝功能的完全恢复时间相对较慢。结论乙型肝炎相关性肝病的肝移植术后急性排斥反应的发生率相对较低;和急性排斥反应发生相关的免疫抑制剂低浓度是诱导急性排斥反应的重要相关因素:FK506为基础的免疫抑制方案,可有效地终止、逆转急性排斥反应,且副作用少。
Objective To determine the incidence, treatment and prevention of early acute rejection after orthotopic liver transplantation （OLT） for treatment of hepatitis B related liver diseases. Methods The morbidity of early acute rejection after OLT in 100 patients with hepatitis B related liver diseases was prospectively studied by analyzing the rejection related factors and the relationship between blood immunosuppressant level and early acute rejection. Results The incidence of early acute rejection after OLT was 12%. There was significantly low blood immunosuppressant level 2-5 d prior to the occurrence of early acute rejection. FK506 as the baseline immunosuppressant with mycophenolate mofetil could successfully reverse the early acute rejection with fewer side effects but longer time for complete recovery as compared with the treatment with pulse of methylprednisolone. Conclusions The incidence of early acute rejection after OLT is relatively low. Lower blood immunosuppressant level is an important factor in inducing the early acute rejection. FK506 as the baseline immunosuppressant with mycophenolate mofetil can successfully reverse the early acute rejection with fewer side effects.
出处
《中华肝胆外科杂志》
CAS
CSCD
2006年第1期30-33,共4页
Chinese Journal of Hepatobiliary Surgery
基金
国家重点基础研究发展计划(973计划)资助项目(课题编号2003CB515507)
关键词
肝移植
急性排斥反应
免疫抑制剂
乙型肝炎
Liver transplantation
Acute rejection
Immunosuppressant
Hepatitis B
