自身免疫性肝炎肝移植术后激素的应用

Application of glucocorticoid after liver transplantation in the treatment of autoimmune hepatitis

摘要:

目的：探讨自身免疫性肝炎（autoimmune hepatitis，AIH）肝移植术后激素的应用特点。方法：以我院和四川大学华西医院2005年1月至2012年1月间实施的99例成人肝移植术后病例为研究对象，分为２组，AIH 36例为观察组，非AIH 63例为对照组。比较2组患者围手术期参数是否存在差异，移植术后为防治排斥反应，激素使用的差异。结果：为了防治排斥反应，保持肝脏及各器官功能稳定，AIH组使用激素比例明显大于非AIH组（P值为0.000），观察组激素使用量[（17.8±5.3） mg/d]及使用时间（385.2±21.7） d明显大于对照组[（9.4±3.9） mg/d，（47.1±11.3） d]（P值均为0.000）。结论：AIH肝移植术后抗排斥时重视激素的长期使用可以有效改善肝移植患者移植效果。

Abstract:

Objective：To evaluate the application characteristics of glucocorticoid after liver transplantation in the treatment of autoim－mune hepatitis（AIH）. Methods：All data was collected from the First Affiliated Hospital of Chongqing Medical University and West China Hospital of Sichuan University，including 99 adult patients with liver transplantation（from January 2005 to January 2012）. All patients were assigned to two groups：36 cases with AIH（observation group） and 63 cases without AIH（control group）. Differences in perioperative parameters and glucocorticoid usages between the two groups were observed. Results：In order to combat rejection，liver and various organ functions remained stable. Glucocorticoid usage was significantly larger in observation group than in control group（P=0.000）. Dosage of glucocorticoid was significantly higher in observation group than in control group（（17.8±5.3） mg/d vs. （9.4±3.9） mg/d）. Duration of using glucocorticoid was significantly longer in observation group than in control group. （385.2±21.7） d vs. （47.1±11.3） d）（P=0.000）. Conclusion：Long-term application of glucocorticoid during immune rejection period can improve trans－plant outcome during immune rejection period for AIH.