非HBV相关性肝病肝移植术后新发HBV感染的相关因素分析及预防建议
|
摘要
目的分析非HBV(乙型肝炎病毒)相关性肝病肝移植术后新发HBV感染的临床表现和预防建议。方法选取本院2016年1月～2019年2月间收治的97例非HBV相关性肝病肝移植术后患者为本研究临床资料,采用统计学分析非HBV相关性肝病肝移植术前以及术后不同原发病(先天性胆道闭锁、自身免疫性肝病、酒精性肝硬化或丙型肝炎硬化等)受体肝移植后乙肝表面抗原状况、受体抗HBs阳性与肝移植后乙型肝炎新发关系、受体抗HBc阴性与肝移植后乙型肝炎新发关系等。结果①不同原发病(先天性胆道闭锁、自身免疫性肝病、酒精性肝硬化或丙型肝炎硬化等)患者的术后乙肝表面抗原阳性率比较,差异有统计学意义(P <0.05);②受体抗HBs阴性患者与受体抗HBs阳性患者术后乙肝表面抗原阳性率比较,差异无统计学意义(P> 0.05);③受体抗HBc阴性患者术后乙肝表面抗原阳性率显著高于受体抗HBc阳性患者(P <0.05)。结论非HBV(乙型肝炎病毒)相关性肝病肝移植术后存在新发乙型肝炎病毒风险,临床需加强预防手段。
Objective To analyze the clinical manifestations and prevention suggestions of new HBV infection after liver transplantation for non-HBV(hepatitis B virus) related liver diseases. Methods 97 patients with non-HBV related liver diseases admitted to our hospital from January 2016 to February 2019 after liver transplantation were selected as clinical data for this study. Statistical analysis was conducted on the hepatitis B surface antigen status, the new relationship between receptor anti-HBs positive and hepatitis B after liver transplantation, and the new relationship between receptor anti-HBc negative and hepatitis B after liver transplantation in different primary diseases(congenital biliary atresia, autoimmune liver disease, alcoholic liver cirrhosis or hepatitis C sclerosis, etc.) before and after liver transplantation. Results ① the positive rate of hepatitis B surface antigen in patients with different primary diseases(congenital biliary atresia, autoimmune liver disease, alcoholic liver cirrhosis or hepatitis c sclerosis, etc.) was statistically significant(P < 0.05). ② there was no significant difference in the positive rate of hepatitis B surface antigen between patients with negative receptor anti-HBs and patients with positive receptor anti-HBs(P > 0.05); ③ the positive rate of hepatitis B surface antigen in patients with negative receptor anti-HBc was significantly higher than that in patients with positive receptor anti-HBc(P < 0.05). Conclusion There is a risk of new hepatitis B virus after liver transplantation for non-HBV(hepatitis B virus)-related liver diseases, and prevention measures should be strengthened clinically.
Objective To analyze the clinical manifestations and prevention suggestions of new HBV infection after liver transplantation for non-HBV(hepatitis B virus) related liver diseases. Methods 97 patients with non-HBV related liver diseases admitted to our hospital from January 2016 to February 2019 after liver transplantation were selected as clinical data for this study. Statistical analysis was conducted on the hepatitis B surface antigen status, the new relationship between receptor anti-HBs positive and hepatitis B after liver transplantation, and the new relationship between receptor anti-HBc negative and hepatitis B after liver transplantation in different primary diseases(congenital biliary atresia, autoimmune liver disease, alcoholic liver cirrhosis or hepatitis C sclerosis, etc.) before and after liver transplantation. Results ① the positive rate of hepatitis B surface antigen in patients with different primary diseases(congenital biliary atresia, autoimmune liver disease, alcoholic liver cirrhosis or hepatitis c sclerosis, etc.) was statistically significant(P < 0.05). ② there was no significant difference in the positive rate of hepatitis B surface antigen between patients with negative receptor anti-HBs and patients with positive receptor anti-HBs(P > 0.05); ③ the positive rate of hepatitis B surface antigen in patients with negative receptor anti-HBc was significantly higher than that in patients with positive receptor anti-HBc(P < 0.05). Conclusion There is a risk of new hepatitis B virus after liver transplantation for non-HBV(hepatitis B virus)-related liver diseases, and prevention measures should be strengthened clinically.
引文
[1]崔羽丰,陆伟,高伟,等.主动免疫在预防HBcAb阳性供肝儿童肝移植术后新发乙型肝炎病毒感染中的应用[J].中华危重病急救医学,2017,29(10):926-930.
[2]章拔翠,陈虹,沈中阳,等.非HBV相关性肝病肝移植术后新发HBV感染的临床分析[J].中华肝脏病杂志,2018,26(5):377-381.
[3]高汇波,代振英.妊娠合并乙型肝炎病毒感染对母儿结局的影响及相关因素分析[J].中国妇幼保健,2016,31(9):1841-1844
[4]李元丰,思兰兰,翟芸,等.全基因组关联研究发现8p21.3区域的INTS10基因是一种新的抑制HBV感染的抗性基因[J].遗传,2016,38(7):674-675.
[5]张凯,徐东平,陈容娟,等.临床大样本肝病患者隐匿性HBV感染检出情况及其HBV S基因免疫逃逸突变特点分析[J].解放军医学杂志,2018,43(5):380-385.
[6]郭朋乐,蔡卫平,陈谐捷,等.合并HBV、HCV感染对获得性免疫缺陷综合征患者死亡原因影响的研究[J].中华肝脏病杂志,2018,26(7):495-498.
[7]俞立飞,卢丹,张永乐,等.CD31分子在T淋巴细胞表面的表达频率和慢性HBV感染关系[J].中华实验和临床病毒学杂志,2016,30(6):499-502.
[8]庄权权,林志航,蒋燕成,等.慢性乙型肝炎病毒感染患者血清免疫调节因子检测的临床意义[J].中华医院感染学杂志,2016,26(1):1-3
[9]刘妍,张凯,陈容娟,等.隐匿性HBV感染患者HBV S基因N-糖基化突变对HBs Ag抗原性影响的分析[J].解放军医学杂志,2018,43(5):386-391.
[10]刘娜,葛军,沈思岚,等.干扰素α调控乙型肝炎病毒特异性T细胞免疫应答抑制慢性感染小鼠模型体内病毒基因表达[J].中国感染与化疗杂志,2018,18(2):177-183.
[11]李照,毛雨鸽,禹琛,等.乙型肝炎相关性肝癌患者肝移植术后肿瘤复发的危险因素分析[J].中华肝脏病杂志,2018,26(2):98-101.
[12]徐琛,何湘漪,张海兵,等.非HBV感染型与HBV感染型原发性肝细胞癌病理特征分析[J].肿瘤学杂志,2017,23(8):672-676.
[2]章拔翠,陈虹,沈中阳,等.非HBV相关性肝病肝移植术后新发HBV感染的临床分析[J].中华肝脏病杂志,2018,26(5):377-381.
[3]高汇波,代振英.妊娠合并乙型肝炎病毒感染对母儿结局的影响及相关因素分析[J].中国妇幼保健,2016,31(9):1841-1844
[4]李元丰,思兰兰,翟芸,等.全基因组关联研究发现8p21.3区域的INTS10基因是一种新的抑制HBV感染的抗性基因[J].遗传,2016,38(7):674-675.
[5]张凯,徐东平,陈容娟,等.临床大样本肝病患者隐匿性HBV感染检出情况及其HBV S基因免疫逃逸突变特点分析[J].解放军医学杂志,2018,43(5):380-385.
[6]郭朋乐,蔡卫平,陈谐捷,等.合并HBV、HCV感染对获得性免疫缺陷综合征患者死亡原因影响的研究[J].中华肝脏病杂志,2018,26(7):495-498.
[7]俞立飞,卢丹,张永乐,等.CD31分子在T淋巴细胞表面的表达频率和慢性HBV感染关系[J].中华实验和临床病毒学杂志,2016,30(6):499-502.
[8]庄权权,林志航,蒋燕成,等.慢性乙型肝炎病毒感染患者血清免疫调节因子检测的临床意义[J].中华医院感染学杂志,2016,26(1):1-3
[9]刘妍,张凯,陈容娟,等.隐匿性HBV感染患者HBV S基因N-糖基化突变对HBs Ag抗原性影响的分析[J].解放军医学杂志,2018,43(5):386-391.
[10]刘娜,葛军,沈思岚,等.干扰素α调控乙型肝炎病毒特异性T细胞免疫应答抑制慢性感染小鼠模型体内病毒基因表达[J].中国感染与化疗杂志,2018,18(2):177-183.
[11]李照,毛雨鸽,禹琛,等.乙型肝炎相关性肝癌患者肝移植术后肿瘤复发的危险因素分析[J].中华肝脏病杂志,2018,26(2):98-101.
[12]徐琛,何湘漪,张海兵,等.非HBV感染型与HBV感染型原发性肝细胞癌病理特征分析[J].肿瘤学杂志,2017,23(8):672-676.