慢性乙型肝炎病毒感染对妊娠期糖尿病的影响  

Effection of chronic hepatitis B virus infection to gestational diabetes mellitus

作　　者：王晓娟[1] 姜秀娟[1] 易为[1] 谢尧[2] 刘敏[1] 万钢[3] 

机构地区：[1]首都医科大学附属北京地坛医院妇产科,北京100015 [2]首都医科大学附属北京地坛医院肝病中心,北京100015 [3]首都医科大学附属北京地坛医院病案科,北京100015

出　　处：《中华实验和临床感染病杂志（电子版）》2014年第4期25-28,共4页Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)

基　　金：北京市科委基金(No.D121100003912001);十一五重大专项(No.2008ZX10002-001)

摘　　要：目的探讨不同乙型肝炎病毒(HBV)感染状态对妊娠期糖尿病(GDM)发生率及妊娠结局的影响。方法利用医院电子病历系统回顾性收集首都医科大学附属北京地坛医院分娩的HBV感染孕妇和非HBV感染孕妇,根据HBV感染状态分为慢性HBV携带组(A组),非活动性HBsAg携带组(B组),慢性乙型肝炎组(C组)和非HBV感染组(U组),比较各组孕妇GDM的发生率,以及各组中GDM孕妇的妊娠结局。结果共收集到符合条件孕妇4 217例,其中A组1 726例,B组1 134例,C组546例,U组811例。各组孕妇年龄、肝功能和GDM发病率差异均具有统计学意义(P分别为0.000、0.000和0.002),各组GDM发病率分别为29.9%(517/1 726)、35.4%(401/1 134)、37.6%(205/546)和32.8%(266/811)。经Logistic回归分析,年龄、肝功能状态是GDM发病的高风险因素(P<0.0001和0.0182),不同HBV感染状态并不增加GDM的发生率(P均>0.05)。对GDM孕妇及新生儿,HBV感染状态不增加剖宫产、产后出血、羊水过多、羊水过少、羊水Ⅲ度粪染及早产率(P均>0.05),对新生儿出生体重、身长、分娩孕周及畸形率均无影响(P均>0.05),但合并慢性乙型肝炎者新生儿窒息发生率高(2.4%,P=0.016)。结论年龄、肝功能状态是GDM发生的高风险因素。HBV感染状态不增加GDM的发病率,不影响GDM孕妇的妊娠结局,但GDM合并慢性乙型肝炎者应注意新生儿窒息的发生。Objective To investigate the effect of different status of hepatitis B virus （HBV） infection on the incidence and pregnancy outcome of gestational diabetes mellitus （GDM）. Methods Pregnant women with or without HBV infection who delivered in Beijing Ditan Hospital, Capital Medical University were collected, retrospectively, through the hospital information system （HIS）. They were divided into four groups： chronic HBV carriers （group A）, inactive HBsAg carriers （group B）, chronic hepatitis B （group C） and patients without HBV infection （group U）. The incidence and pregnancy outcome of GDM were compared in the groups, respectively. Results Total of 4 217 pregnant women met the requirements were collected, which 1 726 cases in group A, 1 134 cases in group B, 546 cases in group C and 811 cases in group U. The incidence of GDM in the four groups were 29.9% （517/1 726）, 35.4% （401/1 134）, 37.6% （205/546） and 32.8% （266/811）, respectively. The difference of GDM incidence, liver function and age were significantly different in the four groups （P = 0.000, 0.000 and 0.002, respectively）. Through the analysis of Logistic regression, age and liver function were risk factors for GDM （P 〈 0.0001, P = 0.0182）, and the status of HBV infection is not a risk factor （P 〉 0.05）. To the pregnant women with GDM, the different status of HBV infection didn＇t increase the rate of cesarean section, postpartum hemorrhage, polyhydramnios, oligohydramnios, meconium staining of the amniotic fluid III degrees and premature delivery （P all 〉 0.05）. To the infants, it had no effects on the length, weight, Apgar at one minute and the rate of congenital abnormality （P all 〉 0.05）. But the rate of neonate asphyxia were higher in infants whose mother had both GMD and chronic hepatitis B （2.4%, P = 0.016）. Conclusions Age and liver function are high risk facters for GDM. The incidence of GDM and pregnancy outcome do not changed by different status of HBV infection.Neonat

关 键 词：肝炎 乙型 慢性 妊娠糖尿病 妊娠 

分 类 号：R714.25[医药卫生—妇产科学]