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目的研究肝移植患者术中和术后早期经不同方法应用乙型肝炎免疫球蛋白(HBIG)对血清乙型肝炎表面抗原(HBsAg)、乙型肝炎e抗原(HBeAg)和乙型肝炎病毒(HBV)-DNA阴转速度的影响。方法将入选的乙型肝炎相关性肝病肝移植患者随机分为3组,每组30例。静脉注射组(静注组):通过静脉注射给予HBIG;肌肉注射组(肌注组):通过肌肉注射给予HBIG;序贯给药组(序贯组):即先静脉注射后肌肉注射给予HBIG。每组均在联合使用拉米夫定的情况下,于术中和术后6 d内给予相同剂量的HBIG。术后7 d内动态观察HBsAg、HBeAg和HBV-DNA的血清学转化情况。结果静注组和序贯组血清HBV-DNA在术后第2天全部转阴,肌注组第4天全部转阴。静注组和序贯组HBeAg于第3天全部转阴,肌注组于第4天全部转阴。静注组和序贯组HBsAg于第4天全部转阴,而肌注组经在第4天和第5天追加HBIG用量后,于第6天才全部转阴;静注组和序贯组术后5 d内每个时间点HBsAg的阴转率都显著高于肌注组(P<0.05)。结论静脉给药和序贯给药的血清HBV-DNA、HBeAg及HBsAg的阴转速度都显著快于肌肉注射给药,而序贯给药不仅能获得静脉给药的等同效果,且简单、易行,是一种更为合理的给药方法。
Objective To study the effects of hepatitis B immunoglobulin (HBIG) on the serum levels of hepatitis B virus surface antigen (HBsAg), hepatitis B e antigen (HBeAg) and hepatitis B virus (HBV) by using different methods during operation and early after liver transplantation. ) -DNA effect of negative rotation speed. Methods Selected patients with hepatitis B-related liver disease were randomly divided into 3 groups, 30 cases in each group. Intravenous injection group (intravenous group): HBIG given intravenously; intramuscular injection group (intramuscular injection group): HBIG administered intramuscularly; sequential injection group (sequential group): intraperitoneal injection of HBIG . Each group was given the same dose of HBIG intraoperatively and within 6 days after the combination of lamivudine. The serological transformation of HBsAg, HBeAg and HBV-DNA were observed dynamically within 7 days after operation. Results Serum HBV-DNA in the intravenous group and sequential group all turned negative on the second day after operation, and the fourth day in the intramuscular group turned negative. In the intravenous group and the sequential group, HBeAg all turned negative on the third day, and the intramuscular injection group turned negative on the fourth day. HBsAg in the intravenous group and sequential group all turned negative on the 4th day, while the intramuscular group was completely negative on the 6th day after adding the HBIG dosage on the 4th and 5th days; the intravenous group and the sequential group Negative conversion rate of HBsAg in each time point after 5 days was significantly higher than that in intramuscular injection group (P <0.05). Conclusion Intravenous administration and sequential administration of serum HBV-DNA, HBeAg and HBsAg were significantly faster than the intramuscular injection of administration, and sequential administration can not only get the same effect of intravenous administration, and simple, easy Line, is a more reasonable method of administration.