摘要
目的探讨免疫抑制剂导致乙型肝炎病毒(HBV)再激活所致肝功能损害的严重性及防治。方法回顾性分析11例慢性HBV感染在使用免疫抑制剂导致HBV再激活并肝功能损害加重患者的临床资料。结果 11例患者HBV再激活后均出现不同程度肝功能异常,其中4例症状相对较轻、无并发症的患者1个月内出院,2例重型肝炎患者分别治疗43.52 d出院,5例患者病情发展迅速,进展至肝衰竭,经积极治疗后死亡,病死率达45.46%(5/11)。结论接受免疫抑制剂治疗前患者应筛查HBsAg和抗-HBc,预防性使用核苷类似物抗病毒治疗,可以明显降低HBV再激活相关发病率和病死率,在免疫抑制剂治疗前和治疗中都应使HBV降至尽可能低的水平。
Objective To explore the severity and therapy of immunosuppressant-induced hepatitis＇ B virus （HBV） reactivation. Methods Clinical data of 11 patients with immunosuppressant-induced HBV reactivation and aggravated liver dysfunction were retrospectively analyzed. Results All patients had different degrees of abnormalities of liver function after HBV reactivation. Among them, 4 patients with relatively mild symptoms,without complications were hospitalized for less than 1 month before discharged, 2 cases of severe hepatitis patients were in the hospital 43 days and 52 days, respectively, and 5 patients with rapid disease progression to liver failure died after active treatment. The mortality was 45.46% （5/11）. Conclusion Both HBsAg and anti-HBc should be screened before immunosuppressive therapy in HBV patients. Prophylactic therapy with nucleoside analogues can obviously reduce HBV reactivation-related morbidity and mortality. HBV load should be reduced as low as possible before and during immunosuppressive therapy.
出处
《实用临床医学（江西）》
CAS
2013年第6期35-37,44,共4页
Practical Clinical Medicine
