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Study of HCV genotype and histopathology on post-transplant recurrent hepatitis C
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- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF ORGAN TRANSPLANTATION
- Issue:
- 1
- DOI:
- 10.3760/cma.j.issn.0254-1785.2004.01.004
- Key Word:
- 肝移植;肝炎,丙型;肝炎病毒;基因型;活组织检查
Abstract： 目的观察同种原位肝移植术(OLT)后复发性丙型肝炎的病理学改变,并探讨不同基因型丙型肝炎病毒(HCV)所致肝炎的各自特点.方法收集50例肝移植后HCV RNA病毒基因型检测资料及移植肝组织病理资料,评价HCV病毒基因型与肝炎活动度、肝纤维化分期、肝脂肪变程度的关系,分析复发性丙型肝炎的病理演变过程及特点.结果 50例患者可检测到HCV 1a、1b、2、3a和4基因型,各基因型所致的丙型肝炎在肝炎活动度、肝纤维化分期上的差异无显著性,但在肝脂肪变方面的差异有显著性,HCV 3a型和HCV 2型感染组肝脂肪变程度明显高于HCV 1、4型感染组(P＜0.05);复发性丙型肝炎的演变过程为非特异性改变期-早期丙型肝炎期-典型丙型肝炎期-进展期丙型肝炎期;随术后时间的延长,肝炎活动度和肝纤维化分期均逐渐加重(P＜0.05),而肝脂肪变程度则随术后时间的延长而逐渐减轻;有12例合并排斥反应.结论 OLT后复发性丙型肝炎的病理改变与感染的病毒基因型有关;尽早确立诊断并给予治疗,对减缓肝硬化进程,延长移植肝的存活时间具有重要意义.
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