目的了解经导管射频消融患者乙型肝炎病毒(HBV)感染情况,探讨重复使用消融导管的安全性。方法采用ELISA法对部分重复使用消融导管的440例随访患者[平均(32±25)个月]行HBV血清学5项指标(两对半)及肝功能检测,检验结果与术前资料比较。结果本组患者术后HBV总感染率为4682%(206/440),与术前2363%(104/440)相比差异有显著性(P<005),但并不高于一般社会人群HBV总感染率(576%);术后HBsAg阳性率为432%(19/440),与术前409%(18/440)相比差异无显著性(P>005);术后抗HBs阳性率为3659%(161/440),与术前1956%(86/440)相比差异具有显著性(P<005);术后抗HBs、抗HBe和抗HBc同时阳性33例,阳性率为750%,与术前114%(5/440)相比差异有显著性(P<005)。随访发现无一例术前HBV阴性而术后携带HBV病毒,也无一例有临床肝病表现,肝功能与术前相比差异无显著性(P>005)。结论重复使用消融导管虽然增加了感染HBV的机会,但总的转归是好的,部分患者术后产生了保护性抗体。 Objective To investigate the status of Hepatitis B virus (HBV) infection in patients undergoing catheter ablation and discuss the safety of re-using ablation catheter. Methods Serum 5 HBV markers (two and a half) and liver function were tested by ELISA in 440 follow-up patients (mean 32 ± 25 months) who underwent partial ablation of ablation catheters. The test results were compared with preoperative data. Results The total postoperative HBV infection rate in this group was 4682% (206/440), which was significantly different from that of preoperative 2363% (104/440) (P <0.05), but not higher than that of the general public (576%). The positive rate of postoperative HBsAg was 432% (19/440), which was not significantly different from the preoperative 409% (18/440) (P> 005) (36/59) (161/440), which was significantly different from that of preoperative 1956% (86/440) (P <0.05). The positive rates of anti-HBs, anti-HBe and anti-HBc were 33 %, Compared with 114% before surgery (5/440), the difference was significant (P <005). Follow-up found no case of preoperative HBV-negative and post-operative carry HBV virus, and no case of clinical liver disease performance, liver function compared with preoperative no significant difference (P> 005). Conclusion Reuse of ablation catheters increases the chances of HBV infection, but the overall outcome is good. Some patients have developed protective antibodies after surgery.