|本期目录/Table of Contents|

[1]童 强,姚立欣,羊继平,等.肝炎病毒阳性患者肾移植术后肝损害的 临床研究[J].医学研究与战创伤救治(原医学研究生学报),2008,10(02):93-96.
　TONG Qiang,YAO Li-xin,YANG Ji-ping,et al.Clinical research on the liver damage in the patients with viral hepatitis after renal transplantation[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2008,10(02):93-96.
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肝炎病毒阳性患者肾移植术后肝损害的 临床研究()
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《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第10卷
期数:
2008年02期
页码:
93-96
栏目:
出版日期:
2008-03-20

文章信息/Info

Title:
Clinical research on the liver damage in the patients with viral hepatitis after renal transplantation
文章编号:
1672-271X(2008)02-0093-04
作者:
童 强; 姚立欣; 羊继平; 黄金明; 邱 军; 刘 军; 陈玉石
解放军第85医院泌尿外科，上海 200052
Author(s):
TONG Qiang; YAO Li-xin; YANG Ji-ping; HUANG Jin-ming; QIU Jun; LIU Jun; CHEN Yu-shi
Department of Urology,the 85th Hospital of PLA,Shanghai 200052,China
关键词:
肾移植; 肝炎病毒; 肝损害
Keywords:
Renal transplantation;  Hepatic virus;  Liver damage
分类号:
R699.2
DOI:
-
文献标志码:
A
摘要:
目的 分析肝炎病毒感染对肾移植术后肝损害的影响,以探讨治疗病毒性肝损害的可行办法。方法 回顾性分析肾移植后发生肝损伤者的临床资料，36 例术前肝炎病毒感染者作为阳性组,同期无病毒感染者116 例为阴性组。术后均采用三联免疫抑制方案,同时监测肝功能、HBV-DNA、HCV-RNA及CsA药物浓度,对肝功能异常者停用CsA改用FK506 ,并行保肝治疗,HBV-DNA(+) 者加用拉米夫定抗病毒治疗。结果 不同肝炎病毒感染者术后肝损害发病率均高于无病毒感染者,表明对此类患者肾移植后要注意其肝损害的发生。结论 术前应对肾移植受者的肝脏情况进行严格的综合评估,肝炎病毒携带者接受肾移植后,出现肝功能异常时,应正确区分系药物性肝损害还是病毒性肝损害,及时采取相应处理,并给予护肝治疗，FK506替代CsA治疗肾移植术后肝损害患者副作用小，效果好。
Abstract:
Objective To analyze the influence of hepatic virus infection on the liver damage of recipients with renal allograft, and to explore the treatment for the viral liver damage.Methods The clinical data were analyzed retrospectively.36 cases with the infection of hepatitis virus before operation were divided into positive group, and 116 cases without infection before operation were as negative control.All patients were treated with the similar immunosuppressive agents and liver protective medicine after operation.The liver function test, HBV-DNA, HCV-RNA and the concentration of CsA were monitored.CsA was replaced with FK506 to the patients with abnormal liver function.Lamivudine was added to the treatment for the patients with HBV-DNA positive.Results The incidence rate of liver damage in the patients with different hepatitis virus infection was significantly higher than in those without infection. Our data showed that the liver damage of renal allograft patients with virus infection should be paid more attention.Conclusion The strict evaluation of liver function should be subjected to renal allograft recipients before operation. The liver damage of patients with virus infection should be diagnosed correctly, and be treated with protective drug for liver. The side effect on treatment for liver damage of renal allograft patients is little when CsA replaced by FK506.

参考文献/References:

[1]Fritsche L,Vanrenterghem Y,Nordal KP,et al.Practice variations in the evaluation of adult candidates for cadaveric kidney transplantation[J]. Transplantation,2000,70(10):1492-1497.
[2]Ramos EL,Kasiske BL,Alexander SR, et al.The evaluation of candidates for renal transplantation —the current practice of U.S.transplant centers[J].Transplantation, 1994,57(4):490-497.
[3]Jung YO,Lee YS,Yang WS,et al.Treatment of chronic hepatitis B with lamivudine in renal transplant recipients[J].Transplantation,1998,66(6)∶733-737.
[4]Davis-Neto E,Da Fonseca JA, De Paula FJ,et al.The impact of azathioprine on chronic viral hepatitis in renal transplantation:a long-term,single center, prospective study on azathioprine withdrawal[J]. Transplantation,1999,68(7):976-980.
[5]Ying C,De Clercq E,Neyts J.Ribavirin and mycophenolic acid potentiate the activity of guanine and diaminopurine-based nucleoside analogues against hepatitis B virus[J].Antiviral Res,2001,48(2):117-123.
[6]苏泽轩，于立新，黄结夫. 现代移植学[M].北京:人民卫生出版社，2005:423-424.
[7]Boletis J,Delladetsima J, Psimenou E,et al.Liver biopsy is essential in anti-HCV renal transplant patients irrespective of liver function tests and serology for HCV[J].Transplant Proc,1995, 27(1)∶945-949.
[8]夏穗生. 临床移植医学[M].杭州: 浙江科学技术出版社,1999:273.
[9]Kletzmayr J,Watschinger B, Muller C,et al.Twelve months of lumivudine treatment for chronic hepatitis B virus infection in renal transplant recipients[J]. Transplantation,2000,70(9):1404-1407.
[10]Mosconi G,Scolari C,Manna C,et al.Lamivudine in recurrent hepatitis B after renal transplantation[J]. Transplant Proc,2001,33(1-2) :1873-1874.
[11]明爱民，林民专，赵 明,等.他克莫司替代环孢素A 在肾移植术后肝功能损害患者中的应用.临床泌尿外科杂志,2003,18(5):259-260.
[12]Miller J,Mendez R,Pirsch JD,et al.Safety and efficacy of tacrolimus in combination with mycophenolate mofetil in cadveric renal transplant recipients[J].Transplantation,2000,69(5):875-880.
[13]Dhar DK,Nagasue N,Kimoto T,et al.The salutary effect of FK506 in ischemia-reperfusion injury of the canine liver[J].Transplantation,1992,54(4):583-588.

相似文献/References:

[1]陈兴东,朱 役,段满林,等.腰-硬联合麻醉对肾移植术患者血流动力学的影响[J].医学研究与战创伤救治(原医学研究生学报),2009,11(06):539.

备注/Memo

备注/Memo:
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更新日期/Last Update: 2013-11-22