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目的评价 adefovir 在预防肝移植后乙肝复发中的应用效果及安全性。方法统计30例应用 lamivudine 出现耐药及病毒变异的肝移植病例加用 adefovir 后病人:ALT、HBV-DNA、Cr 以及 HBeAg 的变化,以及观察 adefovir 的副作用。结果应用 adefovir12周后,ALT 恢复正常者占65.5%,HBVDNA 转阴(<10~4拷贝/ml)占76.7%,HBeAg 转阴44%,未发现严重的肾功能异常及其它副作用。结论肝移植术后应用 lamivudine 出现耐药及病毒变异病例,及时加用 adefovir 可有效改善肝功能、抑制肝炎复发。
Objective To evaluate the efficacy and safety of adefovir in preventing hepatitis B recurrence after liver transplantation. Methods The changes of ALT, HBV-DNA, Cr and HBeAg in 30 patients with adefovir after drug-resistant and virus-resistant liver transplantation were observed and 30 side effects of adefovir were observed. Results After adefovir treatment for 12 weeks, 65.5% returned to normal ALT, 76.7% had negative HBVDNA (<10 ~ 4 copies / ml), and 44% HBeAg was negative. Serious renal dysfunction and other side effects were not found. Conclusions The application of lamivudine after liver transplantation shows resistance and virus mutation cases. Adefovir can be used to improve liver function and inhibit the recurrence of hepatitis.