中文摘要：

目的观察乙肝患者肝移植术后血清5项指标及HBV DNA含量的变化并分析其临床意义。方法选择2006年10月-2007年3月在解放军第302医院施行肝移植术且术前采用拉米夫定治疗的35例乙肝患者为研究对象,采用ELISA法测定手术前、后血清5项指标,采用荧光PCR法测定血清HBV DNA含量变化。选择拉米夫定治疗前HBV DNA高于10000U/ml的45例乙肝患者作为对照,测定用药前和用药2周后血清乙肝5项指标和HBV DNA。结果35例肝移植患者中移植后第2天,除1例术前、术后乙肝5项和HBV DNA无明显变化外,其余34例肝移植患者的血清HBsAg和HBV DNA全部转阴,HBsAb全部转阳。其中11例大三阳患者的HBeAg全部转阴,6例发生从HBeAg到HBeAb的血清学转换,但移植前后血清HBcAb均无变化。45例拉米夫定对照患者均未发生HBsAg阴转和HBsAb阳转的现象,11例患者血清HBV DNA含量下降到500U/ml以下,29例血清HBV DNA含量下降,但持续高于1000U/ml,5例患者的HBV DNA无明显变化。在34例大三阳患者中,有29例患者HBeAg转阴但未发生HBeAb阳转现象。结论肝移植术外加抗病毒和免疫学的综合治疗方案,可使97%的乙肝患者彻底清除血清HBV DNA,并发生HBsAg、HbeAg的血清转换。

英文摘要：

Objective To study the changes and significance of HBV DNA and it＇s antigen and antibody in patients with liver transplanting.Methods 35 cases with liver transplanting in 302th hospital from Oct.2006 to Mac.2007 has been studied.The HBV antigen and antibody has been studied by ELISA in 188 samples including one from before transplanting and 4 to 7 from after transplanting.The quantitative of HBV DNA has been detected by real time PCR technology.45 cases of hepatitis B,whose sera HBV DNA is positive no more than 10 000U/ml,treated with lamifudine in 2 weeks about has been used in controls.Results 95（34/35）percent of liver-transplanting patients acquired serum-transfer in HbsAg to it＇s antibody,and 6 patients with HBeAg positive acquired from HbeAg to it＇s antibody in 2 days after transplanting.The HBV DNA in sera is distinguished of 34 cases from 35s in 6 months after liver-translpanting.Only one patient is insisting with HBsAg and HBV DNA positive.In lamifudine treatment controls,none of patients acquired sera-transferred from HBsAg to antibody in 45 cases.The HBV DNA is decreased from positive to negative under cove in 11 controls.29 cases of HBV DNA are decreased in 2 to 3 Log E after treatment with lamifudine.The HBV DNA is insisting in high levels in 5 patients.The HBeAg is negative in 29 cases after lamifudine treatment,but it＇s antibody is not acquired serum transferring.Conclusion The HBV DNA,HbsAg and HbeAg in patients with HBV infection may be transferred into negative forever transplanting with healthy liver underlined in HBIG and lamfudine treatment.