乙型肝炎病毒感染与妊娠肝内胆汁淤积症的相关性研究  

Evaluation of the relationship between hepatitis B virus infection and intrahepatic cholestasis of pregnancy

作　　者：丁依玲[1] 谭辉[1] 王丽琼[1] 

机构地区：[1]中南大学湘雅二医院妇产科,长沙410011

出　　处：《中国实用妇科与产科杂志》2004年第1期31-33,共3页Chinese Journal of Practical Gynecology and Obstetrics

摘　　要：目的　探讨无症状乙型肝炎病毒 (HBV)感染是否会影响妊娠肝内胆汁淤积症 (ICP)的发生率、病程及相关并发症。方法　 1997年 1月至 2 0 0 1年 7月对 76 5 1例孕妇进行乙型肝炎 (乙肝 )血清学测定 ,分析比较乙肝血清学HBV表面抗原 (HBsAg)、HBVe抗原 (HBeAg)及HBV核心抗体 (HBcAb)阳性孕妇与阴性孕妇其ICP发生、转归的相关性。结果　在有HBV感染的孕妇中其ICP的发生率明显高于无HBV感染的孕妇 (分别为 9 7%及 4 2 % ,P <0 0 0 1)。有HBV感染的孕妇发生ICP瘙痒症状的时间明显早于无HBV感染的孕妇 ,分别为( 2 8 8± 3 2 )周及 ( 32 1± 2 7)周 ,P <0 0 0 1。有HBV感染的ICP孕妇终止妊娠时间明显早于无HBV感染的ICP孕妇 ,分别为 ( 36 1± 0 9)周及 ( 37 8± 1 6 )周 ,P <0 0 0 1。在ICP组中有无HBV感染其早产发生率差异有非常显著性意义 ,分别为 2 9 5 %及 12 2 % ,P <0 0 0 1。ICP孕妇中有无HBV感染产后 2 4h内阴道出血量差异也有非常显著性意义 ,分别为 ( 335 0± 76 7)mL及 ( 2 78 0± 97 6 )mL ,P<0 0 0 1。结论　感染了HBV的孕妇其ICP的发生率增高 ,应加强对这些孕妇的孕期监护 ,并且积极防治早产及产后出血的发生。Objective To explore if the presence of HBV infection without clinical symptoms influences the incidence,course and associated complications of intrahepatic cholestasis of pregnancy(ICP).Methods HBV was determined in 7651 pregnant women with ELISA from January 1997 to July 2001.We studied the incidence course and prognosis of ICP between women with HBsAg(+),HBeAg(+),HBcAb(+) and those without HBV positive.Results The incidence of ICP was greater in women who were infected by HBV than those without infected (9 7% vs 4 2%,P<0 001).Among women with ICP,gestational week at onset of pruritus and termination of pregnancy were significantly earlier in women with HBV infection than those without [(28 8±3 2)weeks vs (32 1±2 7)weeks,P<0 001 and (36 1±0 9)weeks vs (37 8±1 6)weeks,P0 001,respectively].The incidence of preterm delivery was significantly different between women with and without HBV infection (29 5% vs 12 2%,P<0 001).The amount of vaginal bleeding following delivery during the first 24 hours in ICP with HBV infection was more than those without HBV infection [(335 0±76 7)mL vs (278 0±97 6)mL,P<0 001].Conclusion Infection with HBV is associated with a higher incidence and an earlier onset of symptoms of ICP.Monitoring perinatal complications of ICP should be strengthened for women with HBV infection.

关 键 词：乙型肝炎病毒感染 妊娠 肝内胆汁淤积症 相关性研究 乙型肝炎 血清学测定 

分 类 号：R714.251[医药卫生—妇产科学]