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发表于 2002-11-7 00:15
我试试翻译如下:
Hepatitis B: Progress in the last 15 years
Liver Transplantation
October 2002, Supplement 1 . Volume 8 . Number 10
Session III-Hepatitis B
Hepatitis B: Progress in the last 15 years
乙肝专题: 肝移植最近15年进展。
2002年10月 第八卷,第10期,附录1
乙肝第三部分,关于最近的15年肝移植进展
Abstract
1. Patients undergoing orthotopic liver transplantation (OLT) for hepatitis
B without effective prophylaxis have a high risk for recurrent infection and
severe graft damage, leading to death or re-OLT.
2. Long-term prophylaxis with hepatitis B immune globulin (HBIg)
significantly reduces the risk for hepatitis B virus (HBV) recurrence and
increases survival. Patients with detectable HBV DNA at the time of OLT have a high risk for recurrence despite HBIg prophylaxis.
摘要:
1。因HBV原因接受原位肝移植(OLC)的病人,如果没有得到有效的预防,那么他们再次感染的可能性很大,并且会引起严重的肝移植破坏,导致死亡或重新接受原位肝移植手术;
2 长期使用HBV免疫球蛋白(HBIG),可以减少再次感染HBV的危险性,延长存活期;HBVDNA阳性的病人,不管是否使用免疫球蛋白,在此时期接受原位肝移植后再次感染的可能性较大;
3. Lamivudine (LAM) therapy for patients with decompensated HBV cirrhosis before OLT results in inhibition of viral replication and clinical
improvement. Its efficacy is limited by the frequent emergence of
LAM-resistant YMDD mutations. The ideal length of therapy with LAM pre-OLT has not yet been defined.
4. Prophylaxis of HBV recurrence with LAM monotherapy is not recommended because of the reappearance of hepatitis B surface antigen after OLT in approximately 50% of patients.
3。对于代谢失调的肝硬化病人,在接受原位肝移植之前,使用拉米可有助于抑制病毒复制,提高临床的效果。
4。不推荐单独使用拉米,因为在接受原位肝移植后,大约有50%的病人被检测出HBV表面抗原阳性;
5. LAM is the best available treatment for patients with established
recurrent hepatitis B. Long-term therapy is associated with the emergence of drug-resistant mutants in up to 60% of patients. Severe hepatitis and liver failure have been described among liver transplant recipients with YMDD mutations.
6. Combination therapy with HBIg and LAM prevents HBV recurrence in 90% to 100% of patients who undergo OLT for hepatitis B. The optimal HBIg protocol in the LAM era is yet to be defined.
5。对于再次感染HBV的病人,拉米是一种比较好的药物;但长期使用拉米治疗会导致产生抗药性的突变异种,比例高达60%;,在肝移植的病例中,肝炎严重和肝功能衰竭病人中发现YMDD突变。
6。使用免疫球蛋白 和拉米联合治疗,有助于防止接受OLT治疗的HBV病人再次感染HBV,有效率达90%-100%,在拉米时代,最佳的免疫球蛋白协议还未确定;
7. Preliminary studies suggest that adefovir dipivoxil inhibits HBV
replication in patients infected with LAM-resistant HBV strains.
8. Fifteen years ago, hepatitis B was regarded as a relative or absolute
contraindication for OLT. Today, hepatitis B is a universally accepted
indication for OLT. (Liver Transpl 2002;8:SS59-S66.)
7。初步研究表明,对于感染抗拉米的HBV病人,阿德福韦有助于抑制HBV的复制;
8。15年前,对OLT来说,HBV是绝对或相对的禁忌候症;今天,HBV已经被广泛接受可以实施OLT。(肝移植,2002;8:S59-S66。)
Publishing and Reprint Information
出版和复印信息(以下翻译略)
From the Hepatology and Liver Transplantation Unit, Fundacion Favaloro,
Buenos Aires, Argentina.
Address reprint requests to Federico G. Villamil, MD, Hepatology and Liver
Transplantation Unit, Fundacion Favaloro, Buenos Aires, Argentina.
Telephone: 54-11-4378-1366; FAX: 54-11-4378-1392; E-mail:
[email protected]
Copyright © 2002 by the American Association for the Study of Liver Diseases
1527-6465/02/0810-1003$35.00/0
doi:10.1053/jlts.2002.35782
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