无症状乙型肝炎病毒感染合并肝内胆汁淤积症孕妇的临床指标及对妊娠结局的影响  

Clinical indexes of pregnant women with asymptomatic hepatitis B virus infection complicated with intrahepatic cholestasis and its effect on pregnancy outcomes

作　　者：黄伟丽 林炳柱 潘伟杰 HUANG Weili;LIN Bingzhu;PAN Weijie(Department of Laboratory,Yunfu Maternal and Child Health Hospital,Guangdong Province,Yunfu 527300,China)

机构地区：[1]广东省云浮市妇幼保健院检验科,广东云浮527300

出　　处：《妇儿健康导刊》2022年第2期39-41,49,共4页JOURNAL OF WOMEN AND CHILDREN'S HEALTH GUIDE

基　　金：广东省云浮市市级医药卫生类科技计划项目(WS201711)。

摘　　要：目的探讨无症状乙型肝炎病毒(HBV)感染妊娠肝内胆汁淤积症(ICP)的临床指标及对妊娠结局的影响。方法选取云浮市妇幼保健院2018年1月至2020年11月收治的100例妊娠HBV感染患者作为研究对象,其中无合并ICP的50例患者为对照组,合并ICP的50例患者为研究组,比较分析两组患者的肝功能指标、甘胆酸、总胆汁酸水平,产后出血量情况以及妊娠结局。结果两组肝功能指标、甘胆酸指标比较,差异无统计学意义(P>0.05);研究组的总胆汁酸水平高于对照组,产后出血发生率高于对照组,产后出血量多于对照组,差异有统计学意义(P<0.05);研究组的新生儿窒息、早产率高于对照组,差异有统计学意义(P<0.05);两组的死胎、低体重儿发生率比较,差异无统计学意义(P>0.05)。结论无症状HBV感染孕妇合并ICP会导致产后出血发生率及出血量增加,并增加新生儿窒息、早产等不良妊娠结局的发生率,临床应加强管理和治疗无症状HBV感染合并ICP。Objective To investigate the clinical indexes of intrahepatic cholestasis of pregnancy(ICP)in pregnant women infected with asymptomatic hepatitis B virus(HBV)and its effect on pregnancy outcomes.Methods A total of 100 pregnant asymptomatic patients with HBV infection treated in Yunfu Maternal and Child Health Hospital from January 2018 to November 2020 were selected as the research objects,including 50 patients without ICP as the control group and 50 patients with ICP as the study group.The liver function indexes,glycocholic acid and total bile acid levels,postpartum hemorrhage and pregnancy outcomes of the two groups were compared and analyzed.Results There were no significant differences in liver function and glycocholic acid between the two groups(P>0.05).The level of total bile acids in the study group was higher than that in the control group,the incidence rate of postpartum hemorrhage in the study group was higher than that in the control group,and the amount of postpartum hemorrhage in the study group was more than that in the control group,the differences were statistically significant(P<0.05).The rates of neonatal asphyxia and preterm delivery in the study group were higher than those in the control group,the differences were statistically significant(P<0.05).There was no significant difference in the incidence of stillbirth and low birth weight infants between the two groups(P>0.05).Conclusion Asymptomatic HBV infected pregnant women with ICP will increase the probability and amount of postpartum hemorrhage,and increase the incidence of adverse pregnancy outcomes such as neonatal asphyxia and preterm delivery.Clinical management and treatment of asymptomatic HBV infected pregnant women with ICP should be strengthened.

关 键 词：无症状乙型肝炎病毒感染 妊娠肝内胆汁淤积症 总胆汁酸水平 妊娠结局 肝功能指标 

分 类 号：R714[医药卫生—妇产科学]