乙型肝炎病毒感染对孕妇妊娠期肝内胆汁淤积症的影响研究  

Influence of hepatitis B virus infection on intrahepatic cholestasis in pregnant women during pregnancy

作　　者：丁霄雁 耿慧[1] 段彼得[1] 

机构地区：[1]淄博市中心医院产科,山东淄博255036

出　　处：《中华医院感染学杂志》2015年第2期433-435,共3页Chinese Journal of Nosocomiology

基　　金：山东省科技厅研究基金资助项目(2013-074DNG)

摘　　要：目的探讨乙型肝炎病毒(HBV)感染对孕妇妊娠期肝内胆汁淤积症(ICP)的影响,为临床采取合理的预防措施、改善妊娠结局提供参考。方法回顾性分析2011年10月-2013年10月在医院产科产检并分娩的孕妇1 200例,根据是否感染乙型肝炎病毒将其分为两组,HBV感染组112例和非HBV感染组1 088例;对比分析两组的ICP发生率和肝功能生化指标:丙氨酸转氨酶(ACT)、谷草转氨酶(AST),以及孕妇瘙痒出现时间、早产、产后出血发生率等。结果 1 200例孕妇中HBV感染112例,感染率为9.3%,发生ICP 54例,发生率为4.5%;HBV感染组的孕妇发生ICP 13例,发生率为11.61%,非HBV感染组的孕妇发生ICP 36例,发生率为3.31%,组间比较差异有统计学意义(P<0.05);HBV感染合并发生ICP的孕妇肝功能指标水平均明显高于非HBV感染的ICP孕妇;HBV感染合并ICP的孕妇皮肤瘙痒出现时间、早产和产后出血发生率均明显高于非HBV感染的ICP孕妇,组间比较差异有统计学意义(P<0.05)。结论乙型肝炎病毒感染参与了妊娠期肝内胆汁淤积症的发生过程,因此要加强对HBV感染孕妇的围生期监护,以便及时诊断和治疗,而且对于HBV合并ICP的孕妇,积极治疗的同时要预防早产和产后出血的发生,以确保能得到较好的妊娠结局。OBJECTIVE To explore the influence of hepatitis B virus（HBV）infection on intrahepatic cholestasis（ICP）in pregnant women during pregnancy so as to take reasonable prevention measures and improve the pregnancy outcomes.METHODS A total of 1 200 pregnant women who underwent prenatal examination and gave birth in the department of obstetrics from Oct 2011 to Oct 2013 were retrospectively analyzed and divided into the HBV infection group with 112 cases and the non-HBV infection group with 1 088 cases according to the status of hepatitis B virus infection;the incidence of ICP,the biochemical indicators for liver function,including alanine aminotransferase and aspartate aminotransferase,time of onset of itching,premature delivery,and the incidence of postpartum hemorrhage were observed and compared between the two groups.RESULTS The HBV infection occurred in112 of 1 200 pregnant women with the infection rate of 9.3%,and the ICP occurred in 54 cases with the incidence rate of 4.5%.The ICP occurred in 13 cases in the HBV infection group with the incidence rate of 11.61% and in36 cases in the non-HBV infection group with the incidence rate of 3.31%,there was significant difference（P〈0.05）.The average level of liver function indicators of the HBV infection pregnant women complicated with ICP was significantly higher than that of the non-HBV infection pregnant women complicated with ICP.The time of onset of itching,premature delivery,and the incidence of postpartum hemorrhage of the HBV infection pregnant women complicated with ICP were significantly higher than those of the non-HBV infection pregnant women complicated with ICP,there was significant difference（P〈0.05）.CONCLUSION The HBV infection involves in the pathogenesis of ICP,thus,it is necessary to strengthen the perinatal care of the pregnant women with HBV infection so as to diagnose and treat in a timely manner and prevent the premature delivery and postpartum hemorrhage for the HBV infection pregnant women complicated with ICP so as to ensure go

关 键 词：乙型肝炎病毒 妊娠期 肝内胆汁淤积症 影响 

分 类 号：R512.62[医药卫生—内科学]