HBV感染及其病毒载量对妊娠期糖尿病孕妇肝功能和妊娠结局的影响  

Influence of HBV infection and viral load on liver function of pregnant women with gestational diabetes mellitus and pregnancy outcomes

作　　者：叶张艳 李妙红[1] 季聪聪 胡玉玲 许芬 YE Zhang-yan;LI Miao-hong;JI Cong-cong;HU Yu-ling;XU Fen(Lishui Central Hospital,Lishui,Zhejiang 323000,China)

机构地区：[1]丽水市中心医院产科,浙江丽水323000

出　　处：《中华医院感染学杂志》2024年第17期2667-2671,共5页Chinese Journal of Nosocomiology

基　　金：浙江省医药卫生科技计划项目(2021ZH064)。

摘　　要：目的分析乙型肝炎病毒(HBV)感染及其病毒载量对妊娠期糖尿病(GDM)孕妇肝功能和母婴结局的影响。方法选取2021年5月-2023年5月丽水市中心医院收治的106例GDM合并HBV感染孕妇为感染HBV组,并根据HBV-DNA载量将其分为HBV-DNA高载量组(n=37),HBV-DNA中载量组(n=34)和HBV-DNA低载量组(n=35),同期选取53例GDM未合并HBV感染孕妇为未感染HBV组,采集孕妇外周静脉血检测肝功能指标血清谷丙转氨酶(ALT)、谷草转氨酶(AST)及总胆红素(TBIL)和糖代谢指标血清空腹血糖(FPG)、餐后2h血糖(2hPG)及糖化血红蛋白(HbAlc),统计孕妇妊娠并发症和新生儿不良结局发生情况。结果感染HBV组GDM孕妇ALT、AST、TBIL、FPG、2hPG和HbAlc水平均高于未感染HBV组(P<0.05);与HBV-DNA低载量组相比,HBV-DNA中、高载量组ALT、AST、TBIL水平升高(P<0.05),HBV-DNA高载量组TBIL水平高于HBV-DNA中载量组(P<0.05);与HBV-DNA低载量组相比,HBV-DNA中、高载量组FPG、2hPG水平升高(P<0.05);感染HBV组胎膜早破、妊娠期高血压及妊娠期肝内胆汁淤积症和新生儿早产、新生儿窒息及低体质量儿发生率高于未感染HBV组(P<0.05),且HBV-DNA高载量组发生率更高(P<0.05)。结论GDM合并HBV感染孕妇妊娠期肝功能受损,HBV-DNA中、高载量肝功能损伤和糖代谢紊乱更严重,HBV感染及HBV-DNA载量对母婴不良妊娠结局均产生一定影响。OBJECTIVE To observe the influence of hepatitis B virus(HBV)infection and viral load on liver function of the pregnant women with gestational diabetes mellitus(GDM)and maternal and neonatal outcomes.METHODS A total of 106 GDM pregnant women who were complicated with HBV infection and were treated in Lishui Central Hospital from May 2021 to May 2023 were assigned as the HBV infection group and were divided into the high-load HBV-DNA group with 37 cases,the medium-load HBV-DNA group with 34 cases,and the low-load HBV-DNA group with 35 cases.Meanwhile,53 GDM pregnant women who were not complicated with HBV infection were chosen as the no HBV infection group.The peripheral venous blood specimens were collected to detect the liver function indexes serum alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL)and glucose metabolism indexes serum fasting plasma glucose(FPG),2h postprandial blood glucose(2hPG),glycosylated hemoglobin Alc(HbAlc).The gestational complications and adverse neonatal outcomes were statistically analyzed.RESULTS The levels of ALT,AST,TBIL,FPG,2 hPG and HbAlc of the GDM pregnant women were higher in the HBV infection group than in the no HBV infection group(P<0.05).The levels of ALT,AST and TBIL of the medium-load HBV-DNA group and the high-load HBV-DNA group were higher those of the low-load HBV-DNA group(P<0.05),and the levels of the above indexes of the high-load HBV-DNA group were higher than those of the medium-load HBV-DNA group(P<0.05).The levels of FPG and 2 h PG of the medium-load HBV-DNA group and the high-load HBV-DNA group were higher than those of the low-load HBV-DNA group(P<0.05).The incidence rates of premature rupture of membranes,gestational hypertension,gestational intrahepatic cholestasis,preterm delivery,neonatal asphyxia and low birth weight were higher in the HBV infection group than in the no HBV infection group(P<0.05);the incidence rates were higher in the high-load HBV-DNA group(P<0.05).CONCLUSION The GDM pregnant women complicated with HBV i

关 键 词：乙型肝炎病毒 病毒载量 妊娠期糖尿病 肝功能 妊娠结局 

分 类 号：R714.256[医药卫生—妇产科学]