妊娠期HBV感染合并肝内胆汁淤积症对妊娠结局的影响  

Influence of gestational HBV infection complicated with intrahepatic cholestasis on pregnancy outcomes

作　　者：肖菊 吴利荣[2] 肖波[1] 方娟 孟婵 XIAO Ju;WU Li-rong;XIAO Bo;FANG Juan;MENG Chan(Wuhan Hanyang Hospital,Wuhan University of Science and Technology Wuhan,Hubei 430000,China;不详)

机构地区：[1]武汉科技大学附属武汉市汉阳医院妇产科,湖北武汉430000 [2]武汉科技大学附属武汉市汉阳医院产科,湖北武汉430000 [3]华中科技大学同济医学院附属武汉儿童医院(武汉市妇幼保健院)妇产科,湖北武汉430014

出　　处：《中华医院感染学杂志》2022年第13期2066-2070,共5页Chinese Journal of Nosocomiology

基　　金：湖北省科研基金资助项目(GH241051)。

摘　　要：目的分析妊娠期乙型肝炎病毒(HBV)感染合并肝内胆汁淤积症(ICP)对妊娠结局的影响。方法选取2017年8月-2020年8月在武汉科技大学附属武汉市汉阳医院妇产科接受治疗的106例妊娠期HBV感染患者,根据其是否合并ICP分为对照组(50例,未合并ICP)与研究组(56例,合并ICP),另取50名同期产检正常孕妇为正常组,比较三组一般资料、生理指标、新生儿早产、低出生体质量、小于胎龄儿发生率等,以Logistic回归模型分析HBV感染合并ICP与妊娠结局的关系。结果研究组、对照组HBV-脱氧核糖核苷酸(HBV-DNA)定量水平高于正常组(P<0.05);三组孕妇羊水过少、产后出血、新生儿窒息、胎儿窘迫、胎儿死亡等发生率对比,无统计学差异;研究组血总胆汁酸(TBA)、门冬氨酸氨基转氨酶(AST)、丙氨酸转氨酶(ALT)高于对照组、正常组(P<0.05);研究组早产、胎膜早破、剖宫产、新生儿低出生体质量、小于胎龄儿发生率高于对照组、正常组,且对照组均高于正常组(P<0.05)。Logistic多因素回归分析显示妊娠期HBV感染、妊娠期HBV感染合并ICP均是妊娠结局的影响因素(P<0.05)。结论妊娠期HBV感染合并ICP会进一步促进不良妊娠结局发生,建议加强妊娠期HBV感染产前管理,预防ICP。OBJECTIVE To observe the influence of gestational hepatitis B virus(HBV)infection complicated with intrahepatic cholestasis of pregnancy(ICP)on pregnancy outcomes.METHODS A total of 106 patients with gestational HBV infection who were treated in obstetrics and gynecology department of Wuhan Hanyang Hospital,Wuhan University of Science and Technology from Aug 2017 to Aug 2020 were enrolled in the study and divided into the control group with 50 cases(without ICP)and the study group with 56 cases(with ICP)according the status of ICP.Meanwhile,50 normal pregnant women who received prenatal checkups were assigned as the normal group.The baseline data,physiological indexes,incidence of premature delivery,low birth weight and neonates less than gestational age were compared among the three groups,and logistic regression model analysis was performed for the relationship between HBV infection complicated with ICP and pregnancy outcomes.RESULTS The quantitative level of HBV-deoxyribonucleic acid(HBV-DNA)of the study group and the control group was significantly higher than that of the normal group(P<0.05).There was no significant difference in the incidence of oligohydramnios,postpartum hemorrhage,neonatal asphyxia,fetal distress or fetal death among the three groups of pregnant women.The levels of total bile acid(TBA),aspartate aminotransferase(AST)and alanine aminotransferase(ALT)of the study group were significantly higher than those of the control group and the normal group(P<0.05).The incidence rates of premature delivery,premature rupture of membranes,cesarean section,low birth weight and neonates less than gestational age were significantly higher in the study group than in the control group and the normal group,which were significantly higher in the control group than in the normal group(P<0.05).Multivariate logistic regression analysis indicated that the gestational HBV infection and gestational HBV infection complicated with ICP were the influencing factors for the pregnancy outcomes(P<0.05).CONCLUSION The gesta

关 键 词：妊娠期 HBV感染 肝内胆汁淤积症 早产 低出生体质量 小于胎龄儿 

分 类 号：R714.25[医药卫生—妇产科学]