慢性乙型肝炎病毒感染孕妇分娩时停用抗病毒治疗的肝生化指标随访观察  

A follow-up observation on hepatic biochemical indexes of pregnant women with chronic hepatitis B virus infection after discontinuing antiviral treatment during delivery

作　　者：周桂生 苏静 龚萍 ZHOU Gui-sheng;SU Jing;GONG Ping(Clinical Laboratory,Kunshan rehabilitation hospital,Kunshan 215314,Jiangsu,China)

机构地区：[1]昆山市康复医院检验科,江苏215314

出　　处：《肝脏》2020年第11期1158-1160,共3页Chinese Hepatology

基　　金：昆山市社会发展科技计划项目(KS1771)。

摘　　要：目的探讨慢性乙型肝炎病毒(HBV)感染孕妇分娩时停用抗病毒治疗后肝生化指标的变化。方法纳入昆山市康复医院2017年8月至2019年8月收治的慢性HBV感染孕妇110例开展回顾性研究,其中有55例接受抗病毒治疗,55例未接受抗病毒治疗,据此分成抗病毒组、对照组。分别在抗病毒干预前、分娩前、产后8周检测两组血常规的变化,包括外周血白细胞计数(WBC)、血小板计数(PLT)、中性粒细胞计数。与此同时,测定两组乙型肝炎病毒DNA(HBV DNA)定量、肌酐(Cr)、总胆红素(TBil)、谷丙转氨酶(ALT)、谷草转氨酶(AST)水平,分析肝生化指标变化。结果两组干预前、分娩前以及产后8周的WBC、PLT、中性粒细胞计数比较无差异(P>0.05)。抗病毒组分娩前、产后8周HBV DNA定量、Cr、TBil、ALT、AST水平较干预前均降低,且抗病毒组各指标较对照组明显下降(P<0.05)。结论慢性HBV感染孕妇在分娩时停药,产后8周内仍未见肝生化指标异常,表明分娩时停药较安全。Objective To explore the changes of liver function of pregnant women with chronic hepatitis B virus(HBV)infection after discontinuing antiviral treatment during delivery.Methods A retrospective study was carried out in 110 pregnant women with chronic HBV infection.They were divided into antiviral group(n=55)and control group(n=55).Patients in the antiviral group had received antiviral treatment,whereas patients in the control group remained untreated.The changes of blood routine test,including white blood cell count(WBC),platelet(PLT)and neutrophil,and the levels of HBV DNA,Creatinine(Cr),Total bilirubin(TBil),Alanine aminotransferase(ALT)and Aspartate aminotransferase(AST)were measured before antiviral treatment,prenatal and 8 weeks after delivery.The changes of liver function were analyzed.Results The cesarean section rate,postpartum hemorrhage rate and adverse pregnancy rate of the antiviral group were 60.00%,25.45%and 9.09%,respectively.There was no difference compared with 56.36%,21.82%and 10.91%of the control group(P>0.05).The HBV DNA quantity,Cr,TBil,ALT,AST in the antiviral group were lower than those in the control group before and 8 weeks after delivery(P<0.05).Conclusion The discontinuing of antiviral drugs during delivery in pregnant women with chronic HBV infection was not associated with abnormal liver function in 8 weeks after delivery,indicating that it was safe to temperately discontinue antiviral treatment during dilivery.

关 键 词：慢性乙型肝炎 孕妇 抗病毒治疗 肝生化指标 

分 类 号：R512.62[医药卫生—内科学]