中文摘要：

目的探讨阿德福韦二匹伏酯（ADV）联合抗乙型肝炎球蛋白（HBIG）预防存在YMDD变异者肝移植后乙型肝炎复发的效果。方法16例患者肝移植前乙型肝炎病毒（HBV）DNA阳性，其HBV DNA聚合酶发生YMDD变异，对拉米夫定产生耐受，术前患者开始口服ADV，并肌肉注射小剂量HBIG，以预防移植后乙型肝炎复发。术后监测移植肝功能以及血清和肝组织中HBV标志物。结果术后平均随访19．4个月，除1例死于肝癌复发外，其余患者存活。15例于术后4周内、1例于术后6个月HBV DNA转阴，此后HBV DNA持续阴性。结论采用ADV联合小剂量HBIG肌肉注射可以有效预防存在YMDD变异者肝移植后的乙型肝炎复发。

英文摘要：

Objective To investigate the prophylactic efficacy of adefovir dipivoxil （ADV） plus hepatitis B immunoglobulin （HBIG） for patients with YMDD mutation after liver transplantation （LT）. Methods Sixteen patients with positive HBV DNA and lamivudine-resistant YMDD mutation detected prior to LT received treatment with ADV, plus intramuscular HBIG, as prophylaxis against graft reinfection after LT. Tests for liver function, the HBV markers of serum and liver tissue were assessed before and after LT. Results The median follow-up period of these patients post-LT was 19. 4 months. Fifteen patients survived except that one patient died of recurrence of HCC. Fifteen patients had undetectable HBV-DNA at 4th week and one patient at 6th month after LT. No patient suffered from hepatitis B recurrence. Conclusion ADV combined with intramuscular HBIG protects patients with YMDD mutation from hepatitis B recurrence after LT.