乙型肝炎病毒感染对妊娠期肝内胆汁淤积症的影响  

Discussion the influence of hepatitis B Virusis infection on theintrahepatic cholestasis of pregllancy

作　　者：潘玥 梅又文 唐太英 

机构地区：[1]成都市妇女儿童中心医院,四川成都610091

出　　处：《四川医学》2012年第7期1159-1161,共3页Sichuan Medical Journal

摘　　要：目的探讨无症状乙型肝炎病毒(HBV)感染对妊娠肝内胆汁淤积症(ICP)的发生率、病情、并发症及妊娠结局的影响。方法采用回顾性方法分析2011年1月～2011年12月期间在我院住院治疗的307例ICP孕妇,其中合并乙肝病毒感染的73例为HBV+ICP组,无乙肝病毒感染的234例为单纯ICP组。通过对比分析,无症状乙型肝炎病毒(HBV)感染对妊娠肝内胆汁淤积症(ICP)的发生率、病情、并发症及妊娠结局的影响。结果所有住院孕妇中未合并HBV感染的孕妇ICP发病率4.27%,合并HBV感染的孕妇ICP发病率14.25%,二者差异有统计学意义(P<0.001)。HBV+ICP组瘙痒出现时间明显早于单纯ICP组,分别为(29.2±4.8)周及(32.6±3.9)周(P<0.01)。二者血清胆汁酸和胆红素的结果差异无统计学意义。两组ICP孕妇的早产、胎儿窘迫、新生儿窒息、小于胎龄儿发生率的差异无统计学意义(P>0.05),但合并HBV组产后24h阴道出血量明显增多,两组差异有统计学意义(P<0.01)。结论无症状HBV感染可使ICP的发生率更高,起病孕周更早,病情相对更重、产后出血等发生率更高。故需加强孕期监护,积极治疗。Objective Discussion the influence of hepatitis B Virusis infection on the incidence,course,related complications and pregnancy outcome of intrahepatic cholestasis of pregllancy（ICP）.Methods 307 cases admitted by our hospital during 2011-01 and 2011-12 were included in our study.Of which 73 cases with hepatitis B infection was the study group,comparied with 234 cases as the simple-ICP patient group.By comparing both groups,the impact of hepatitis B Virusis infection on the incidence,course,related complications and pregnancy outcome of Intrallepatic cholestasis of pregllancy were studied.Results The incidence of ICP was 4.27% among the pregnant women without hepatitis B infection,while 14.25% among the pregnant women with hepatitis B virusis infection.The difference was statistically significant.（P〈0.001）.The itching occurs earlier in ICP with HBV infection group（29.2±4.8） weeks than simple-ICP group（32.6±3.9） weeks（P〈0.001）.There was no significant difference of Serum bile acids and bilirubin between both groups.Perinatal complications shch as premature birth,fetus distress,new-born asphyxia,incidence of smaller than gestational age children between both groups,the difference was not statistically significant（P〈0.05）.However,the volume of postpartum hemorrage in pregnant women with ICP and HBV infection was more than that in pure-ICP pregnant women,the difference was statistically significant.（P〈0.01）.Conclusion HBV infection has a serious impact on Intrallepatic cholestasis of pregllancy with higher incidence rate,earlier itching emerged time,more postpartum hemorrage.Therefor,we should streghthen maternal and childcare and pay great attention to the trement of pregnant women with both ICP and HBV infection.

关 键 词：乙型肝炎病毒 发病率 妊娠结局 妊娠肝内胆汁淤积症 

分 类 号：R714.25[医药卫生—妇产科学]