乙型肝炎病毒感染对妊娠期肝内胆汁淤积症患者母婴免疫系统及妊娠结局的影响  

Effect of hepatitis B virus infection on pregnancy maternal immune system and pregnancy outcomes of pregnant women with intrahepatic cholestasis

作　　者：高翔[1] 张华[1] 庞秋梅[1] 朱云霞[1] 刘俊宝[2] 

机构地区：[1]首都医科大学附属北京佑安医院妇产科,北京100069 [2]吉林大学中日联谊医院妇产科,吉林长春130021

出　　处：《中国医药导报》2015年第21期59-62,共4页China Medical Herald

基　　金：北京市科技计划项目(z131100004013039)

摘　　要：目的 探讨乙型肝炎病毒（HBV）感染对妊娠期肝内胆汁淤积症（ICP）孕妇母儿免疫系统及妊娠结局的影响。方法 收集2009年3月~2015年1月吉林大学中日联谊医院收治的妊娠期肝内胆汁淤积症患者129例并将其作为对照组,收集同期吉林大学中日联谊医院收治的妊娠期肝内胆汁淤积症合并HBV感染患者71例并将其作为研究组。比较两组妊娠结局、新生儿情况及白细胞介素（IL）-18、IL-12、肿瘤坏死因子-α（TNF-α）水平。结果 研究组产后出血率、早产率、剖宫产率与对照组比较明显较高,差异均有统计学意义（P〈0.05）。研究组新生儿体重、低体重儿百分率、Apgar评分与对照组比较差异无统计学意义（P〉0.05）。研究组IL-18、IL-12、TNF-α水平与对照组比较明显较高,差异均有统计学意义（P〈0.05）。结论 ICP孕妇合并HBV感染患者较未合并HBV感染的患者免疫功能降低,更容易引发不良妊娠结局,发生早产、产后出血等各种并发症。ICP孕妇合并HBV感染患者体内IL-18、IL-12、TNF-α水平上升,应采取措施防止早产、产后出血等并发症的发生,以确保母婴健康。Objective To investigate the impact of hepatitis B virus on pregnancy maternal immune system and preg- nancy outcomes of pregnant women with intrahepatic cholestasis. Methods 129 cases with intrahepatic cholestasis of pregnancy were selected from March 2009 to January 2015 in Sino-Japanese Friendship Hospital of Jilin University and considered them as the control group, 71 cases with intrahepatic cholestasis of pregnancy and HBV-infected pa- tients were collected on the same period in Sino-Japanese Friendship Hospital of Jilin University and considered them as the study group. The pregnancy outcomes, newborns, and IL-18, IL-12, TNF-α levels of two groups were compared. Results The rate of postpartum hemorrhage, preterm birth rate, cesarean section rate of the study group was significantly higher than the control group, the difference was statistically significant （P 〈 0.05）. The birth weight, percentage of low birth weight children, Apgar scores of the study group compared with control group showed no significant difference （P 〉 0.05）. IL-18, IL-12, TNF-α levels of the study group were significantly higher comparied with the control group, the differences were statistically significant （P 〈 0.05）. Conclusion ICP HBV infection in pregnant women compared with patients without HBV-infected patients are more likely to lead to adverse pregnancy outcomes, premature delivery, in- crease the risk of postpartum hemorrhage and other complications. ICP pregnant patients with HBV infection in vivo IL-18, increased IL-12, TNF-α levels, should take measures to prevent the occurrence of preterm delivery, postpartum hemorrhage, and to ensure that maternal and child health.

关 键 词：肝内胆汁淤积症 乙型肝炎病毒 免疫系统 妊娠结局 

分 类 号：R575.6[医药卫生—消化系统]