乙型肝炎病毒对妊娠期糖尿病孕妇妊娠结局的影响  

Effect of hepatitis B virus on pregnancy outcome in pregnant women with gestational diabetes mellitus

作　　者：熊霞鹂 朱云霞[1] 魏宏[1] 赵志强[1] 高翔[1] 张志红 孟君[1] XIONG Xiali;ZHU Yunxia;WEI Hong;ZHAO Zhiqiang;GAO Xiang;ZHANG Zhihong;MENG Jun(Department of Obstetrics,Beijing You'an Hospital,Capital Medical University,Beijing 100069,China)

机构地区：[1]首都医科大学附属北京佑安医院产科,北京100069

出　　处：《西部医学》2022年第8期1199-1203,1208,共6页Medical Journal of West China

基　　金：国家科技重大专项(2017ZX10201201-002-009);北京市属医院科研培育计划项目(PX2020067)。

摘　　要：目的观察乙型肝炎病毒(HBV)对妊娠期糖尿病(GDM)患者妊娠结局的影响。方法纳入2019年10月~2021年4月于我院收治的160例GDM患者为研究对象,开展回顾性分析。按照是否存在HBV感染,将所有患者分为观察组(GDM合并HBV感染,96例)和对照组(单纯GDM,64例);观察组根据孕期是否出现肝功能异常分为肝功能异常组(42例)及肝功能正常组(54例)。分别比较观察、对照组以及肝功能异常、肝功能正常组孕妇孕期胰岛素使用率,孕妇在妊娠期高血压疾病(HDCP)、妊娠期肝内胆汁淤积症(ICP)、胎膜早破(PROM)、产后出血(PPH)、早产、剖宫产的发生率;分别比较各组新生儿在分娩时的新生儿窒息、小于胎龄儿(SGA)、巨大儿及新生儿低血糖的发生率。结果观察组孕妇孕期胰岛素使用率,母体并发症如ICP、PPH、早产的发生率均明显高于对照组,差异具有统计学意义(均P<0.05),但两组的剖宫产率比较差异无统计学意义(P>0.05)。观察组新生儿并发症如新生儿窒息、SGA的发生率均明显高于对照组,差异具有统计学意义(均P<0.05)。肝功能异常组患者孕期胰岛素使用率、母体并发症如HDCP、ICP、PPH及早产的发生率均明显高于肝功能正常组,差异具有统计学意义(均P<0.05),但两组剖宫产率比较差异无统计学意义(P>0.05)。肝功能异常组新生儿并发症如新生儿窒息、SGA及新生儿低血糖发生率均明显高于肝功能正常组,差异具有统计学意义(均P<0.05)。结论HBV感染可增加GDM孕妇孕期胰岛素使用率,导致GDM孕妇不良母儿结局增加,且胰岛素使用率及不良母儿结局发生率可能与肝功能相关。Objective To observe the effect of hepatitis B virus(HBV)on pregnancy outcome in patients with gestational diabetes mellitus(GDM).Methods 160 patients with GDM treated in our hospital from October 2019 to April 2021 were included as the research objects,and a retrospective analysis was carried out.According to the existence of HBV infection,all patients were divided into observation group(group A,96 cases of GDM combined with HBV infection)and control group(group B,64 cases of simple GDM).The observation group(group A)was divided into abnormal liver function group(group A1,42 persons)and normal liver function group(group A2,54 persons)according to whether there was abnormal liver function during pregnancy.The use rate of insulin during pregnancy,the incidence of pregnancy induced hypertension(HDCP),intrahepatic cholestasis of pregnancy(ICP),premature rupture of membranes(PROM),postpartum hemorrhage(PPH),preterm birth and cesarean section were compared in groups A and B,A1 and A2.The incidence of neonatal asphyxia(SGA),neonatal asphyxia(SGA)and neonatal asphyxia in each group were compared.Results The use rate of insulin during pregnancy and the incidence of maternal complications such as ICP,PPH and preterm birth in group A were significantly higher than those in group B(all P<0.05),but there was no significant difference in the rate of cesarean section between the two groups(P>0.05).The incidence of neonatal complications such as neonatal asphyxia and SGA in group A was significantly higher than that in group B(all P<0.05).The use rate of insulin during pregnancy and the incidence of maternal complications such as HDCP,ICP,PPH and preterm birth in group A1 were significantly higher than those in group A2(all P<0.05),but there was no significant difference in the rate of cesarean section between the two groups(P>0.05).The incidence of neonatal complications such as neonatal asphyxia,SGA and neonatal hypoglycemia in group A1 was significantly higher than that in group A2(all P<0.05).Conclusion HBV infection can in

关 键 词：乙型肝炎病毒 感染 妊娠期糖尿病 妊娠结局 

分 类 号：R587.1[医药卫生—内分泌] R714.256[医药卫生—内科学]