慢性乙型肝炎孕妇血清HBV载量、INF-γ表达与新生儿结局的相关性分析  

Correlation analysis of serum HBV viral load,INF-γexpression and neonatal outcomes in pregnant women with chronic hepatitis B

作　　者：屈菊梅 张龙[1] 刘荣[1] QU Ju-mei;ZHANG Long;LIU Rong(Department of Neonatology,Yan’an People’s Hospital,Yan’an 716000)

机构地区：[1]延安市人民医院新生儿科,延安716000

出　　处：《生殖医学杂志》2021年第8期997-1001,共5页Journal of Reproductive Medicine

基　　金：陕西省自然科学研究计划项目(2018J08057)。

摘　　要：目的探究慢性乙型肝炎(CHB)孕妇血清乙肝病毒(HBV)载量、干扰素-γ(INF-γ)表达与新生儿结局的相关性。方法选取2017年1月至2019年6月期间在本院住院分娩的CHB孕妇117例为研究组,根据HBV载量是否≥1.0×103 U/ml,分为高载量组(n=70)和低载量组(n=47),同期非CHB健康孕妇152例为对照组,比较研究组和对照组孕妇一般资料信息,比较3组谷氨酰转移酶(GGT)、碱性磷酸酶(ALP)、丙氨酸氨基转移酶(ALT)、谷草转氨酶(AST)水平、AST/ALT值、血清INF-γ水平及新生儿结局情况。多因素Logistic回归分析影响CHB孕妇新生儿结局不良的危险因素。结果研究组与对照组孕妇年龄、分娩孕周、分娩方式、住院时间、妊娠期并发症发生率比较均无显著性差异(P>0.05)。低载量组、高载量组血清INF-γ水平均显著低于对照组(P均<0.05),GGT、ALP、ALT、AST、AST/ALT均显著升高(P均<0.05);与低载量组相比,高载量组血清INF-γ水平显著降低(P<0.05),GGT、ALP、ALT、AST、AST/ALT显著升高(P均<0.05)。与对照组新生儿相比,高载量组、低载量组新生儿身长、体重、呼吸窘迫占比均无显著性差异(P>0.05),高载量组新生儿高胆红素血症占比显著高于对照组(P<0.05)。多因素Logistic回归分析结果显示,HBV载量≥1.0×10^(3 )U/ml、INF-γ<282.02 pg/ml、GGT>110.80 U/L、ALP>135.94 U/L、AST/ALT>0.73是影响CHB孕妇新生儿结局不良的独立危险因素(P均<0.05)。结论CHB孕妇血清HBV载量越高,INF-γ水平越低,新生儿结局不良比例越高;监测二者水平变化可能对临床干预有一定的参考价值。Objective:To explore the correlation between serum hepatitis B virus(HBV)load,interferon-γ(INF-γ)expression and neonatal outcomes in pregnant women with chronic hepatitis B(CHB).Methods:A total of 117 CHB pregnant women who gave birth in our hospital from January 2017 to June 2019 were selected as the study group.The women were divided into the high-load group(n=70)and the low load group(n=47),according to whether HBV load≥1.0×10^(3)U/ml.During the same time,152 healthy non-CHB pregnant women served as the control group.The general information of pregnant women was compared between the study group and the control group.Glutamyltransferase(GGT),alkaline phosphatase(ALP),alanine aminotransferase(ALT),aspartate aminotransferase(AST)levels,AST/ALT ratio,and serum INF-γlevels and neonatal outcomes were compared among the three groups.The risk factors affecting the adverse neonatal outcome of CHB pregnant women were analyzed by using multivariate logistic regression analysis.Results:There were no significant differences in the age of pregnant women,gestational weeks of delivery,mode of delivery,length of hospital stay and complications during pregnancy between the study group and the control group(P>0.05).Compared with the control group,the serum INF-γlevels in the low-load group and high-load group of CHB pregnant women were significantly reduced(P<0.05),and GGT,ALP,ALT,AST levels and AST/ALT ratio were significantly increased(P<0.05).The serum INF-γlevels in high-load group were significantly decreased(P<0.05),while GGT,ALP,ALT,AST and AST/ALT ratio were significantly increased compared with the low-load group(P<0.05).Compared with the control group,the body length,weight,and the proportion of respiratory distress of the neonates were not significantly different in the high-load group and low-load group(P>0.05).The proportion of neonatal hyperbilirubinemia in the high load group was significantly higher than that in the control group(P<0.05).Multivariate logistic regression analysis showed that HBV load≥1.0

关 键 词：慢性乙型肝炎 孕妇 乙肝病毒载量 干扰素-Γ 新生儿结局 相关性 

分 类 号：R715.5[医药卫生—妇产科学]