抗病毒治疗对转氨酶异常HBsAg阳性孕妇母婴结局的影响  

Influence of antiviral therapy on maternal and neonatal outcomes of HBsAg-positive pregnant women with transaminase abnormalities

作　　者：钟歆 张小勤[1] 朱书力 代娟 张绍敏[1] ZHONG Xin;ZHANG Xiao-qin;ZHU Shu-li;DAI Juan;ZHANG Shao-min(People's Hospitalin Banan District,Chongqing401320,China)

机构地区：[1]重庆市巴南区人民医院产科,重庆401320

出　　处：《中华医院感染学杂志》2021年第13期2050-2054,共5页Chinese Journal of Nosocomiology

基　　金：重庆市巴南区科学技术局科技基金资助项目(2019-22)。

摘　　要：目的探究抗病毒治疗对转氨酶异常下乙肝表面抗原(HBsAg)阳性孕妇肝功能、妊娠结局及婴儿乙型肝炎病毒(HBV)感染的影响。方法选取2016年6月-2020年6月重庆市巴南区人民医院收治妊娠期HBV感染合并转氨酶异常孕妇87例,根据患者是否接受抗病毒治疗,分为病毒治疗组(31例)和未病毒治疗组(56例),检测两组孕妇肝功能情况,并统计孕妇妊娠结局及婴儿HBV感染情况。结果与治疗前比较,两组患者治疗1个月、分娩前丙氨酸转氨酶(ALT)、谷草转氨酶(AST)及总胆汁酸(TBA)均下降(P<0.05);其中治疗前和分娩前两组ALT、AST及TBA水平比较,无统计学差异,但治疗1个月时,病毒治疗组上述指标低于未病毒治疗组(P<0.05)。分娩前,病毒治疗组HBV-DNA拷贝数、乙型肝炎e抗原(HBeAg)阳性低于未病毒治疗组(P<0.05)。病毒治疗组妊娠期并发症、早产、产后出血的发生率分别为9.68%、0%、3.22%,分别低于未病毒治疗组(P<0.05);病毒治疗组新生儿出生时HBV-DNA阳性或HBsAg阳性、免疫失败率为3.22%、0%,分别低于未病毒治疗组(P<0.05)。结论对于合并转氨酶异常的HBV感染孕妇,实施抗病毒治疗可改善其肝功能和不良妊娠结局,降低新生儿发生HBV感染风险,较为安全。OBJECTIVE To explore the influence of antiviral therapy on liver function and pregnancy outcomes of the hepatitis B surface antigen(HBsAg)-positive pregnant women as well as hepatitis B virus(HBV)infection in infants.METHODS A total of 87 HBV infection pregnant women complicated with transaminase abnormalities who were treated in the People’s Hospital in Banan District from Jun 2016 to Jun 2020 were enrolled in the study and divided into the antiviral therapy group with 31 cases and the no antiviral therapy group with 56 cases.The liver function indexes of the two groups of pregnant women were detected,and the pregnancy outcomes and incidence of HBV infection in infants were statistically analyzed.RESULTS The levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST)and total bile acid(TBA)of the two groups of patients were significantly lower after the treatment for 1 month or before deliver than before the treatment(P<0.05);there were no significant differences in the levels of ALT,AST and TBA between the two groups before the treatment and before delivery,however,the levels of above indexes of the antiviral therapy group were significantly lower than those of the no antiviral therapy group after the treatment for 1 month(P<0.05).The number of HBV-DNA copies and HBeAg-positive cases was significantly less in the antiviral therapy group than in the no antiviral therapy group before delivery(P<0.05).The incidence rates of gestational complications,premature delivery and postpartum hemorrhage of the antiviral therapy group were respectively 9.68%,0%and 3.22%,significantly lower than those of the no antiviral therapy group(P<0.05).The positive rate of HBV-DNA or HBsAg and immune failure rate of infants of the antiviral therapy group were respectively 3.22%and 0%at their birth,significantly lower than those of the no antiviral therapy group(P<0.05).CONCLUSION The antiviral therapy can improve the liver function and adverse pregnancy outcomes of the HBV infection pregnant women complicated with transam

关 键 词：乙型肝炎病毒感染 妊娠 转氨酶异常 抗病毒治疗 母婴结局 

分 类 号：R714.251[医药卫生—妇产科学]