总胆汁酸升高慢性乙型肝炎孕妇围产结局分析  

Perinatal outcomes of pregnant women with elevated total bile acids and chronic hepatitis B

作　　者：康晓迪[1] 刘军[1] 许艳丽[1] 白玉青[1] 刘华放 蒋红丽[1] 伊诺[1] Kang Xiaodi;Liu Jun;Xu Yanli;Bai Yuqing;Liu Huafang;Yi Nuo(Department of Obstetrics,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China)

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

出　　处：《中国肝脏病杂志（电子版）》2021年第1期68-72,共5页Chinese Journal of Liver Diseases：Electronic Version

基　　金：首都特色应用研究(Z14110700250000、Z141107002514140);北京市医管局市属医院科研培育计划(PX2018060);北京市医管局青苗计划(QML20171803)。

摘　　要：目的探讨总胆汁酸(total bile acid,TBA)升高慢性乙型肝炎(chronic hepatitis B,CHB)孕妇的围产结局。方法回顾性分析2016年12月至2018年10月在首都医科大学附属北京地坛医院产检并分娩的83例CHB孕妇的临床资料,依据入院治疗过程中最高TBA水平分为A组(24例,10μmol/L<TBA<40μmol/L),B组(21例,TBA≥40μmol/L)和C组(38例,0μmol/L<TBA≤10μmol/L),比较各组孕妇围产结局及新生儿结局的差异。结果A组、B组和C组医源性早产发生率分别为16.67%(4/24)、42.86%(9/21)、5.26%(2/38),差异有统计学意义(P=0.002);自发性早产发生率分别为4.17%(1/24)、4.16%(1/21)、0.00%(0/38),差异无统计学意义(P=0.291)。A组、B组、C组胎儿宫内窘迫及新生儿窒息发生率分别为8.33%(2/24)、19.05%(4/21)、0%(0/38),差异有统计学意义(P=0.015);羊水粪染发生率分别为13.16%(4/24)、16.67%(5/21)、23.81%(5/38),差异无统计学意义(P=0.524)。A组、B组、C组产妇足月分娩新生儿体质量分别为(3273.02±361.39)g、(3202.71±369.69)g、(3373.02±359.79)g,差异无统计学意义(F=2.885,P=0.062)。结论TBA升高CHB孕妇胎儿宫内窘迫、新生儿窒息及医源性早产发生率升高,但自发性早产发生率未增加。Objective To investigate the perinatal outcomes of pregnant women with elevated total bile acids(TBA)and chronic hepatitis B(CHB).Methods The clinical data of 83 pregnant women with CHB in Beijing Ditan Hospital,Capital Medical University from December 2016 to October 2018 were retrospectively analyzed.The patients were divided into group A(24 cases,10μmol/L<TBA<40μmol/L),group B(21 cases,TBA≥40μmol/L)and group C(38 cases,0μmol/L<TBA≤10μmol/L)according to the highest levels of TBA during the treatment.The incidence of adverse perinatal outcomes and neonatal outcomes were compared.Results The incidence of preterm delivery were 16.67%(4/24),42.86%(9/21)and 5.26%(2/38)in group A,group B and group C,respectively,the difference was statistically significant(P=0.002).The incidence of spontaneous preterm birth were 4.17%(1/24),4.16%(1/21)and 0.00%(0/38)in group A,group B and group C,respectively,the difference was not statistically significant(P=0.291).The incidence of fetal distress and neonatal asphyxia were 8.33%(2/24),19.05%(4/21)and 0%(0/38)in group A,group B and group C,respectively,the difference was statistically significant(P=0.015).The incidence of amniotic fluid meconium pollution were 13.16%(4/24),16.67%(5/21)and 23.81%(5/38)in group A,group B and group C,respectively,the difference was not statistically significant(P=0.524).The birth weight of term infants were(3273.02±361.39)g,(3202.71±369.69)g and(3373.02±359.79)g in group A,group B and group C,respectively,the difference was not statistically significant(F=2.885,P=0.062).Conclusions The incidence of preterm delivery,fetal distress and neonatal asphyxia increased,however,the incidence of spontaneous preterm birth did not increase.

关 键 词：肝炎 乙型 慢性 孕妇 妊娠期肝内胆汁淤积症 总胆汁酸 围产结局 

分 类 号：R714.251[医药卫生—妇产科学]