摘要
目的研究妊娠中晚期重型病毒性肝炎(以下简称重肝)对孕妇及胎儿预后的影响。方法观察引起妊娠中晚期重肝的感染病原体,比较各型各期患者的病死率、存活组和死亡组之间各项指标、并发症发生的差异以及胎儿病死率与HBV感染的关系。结果HBV相关、HEV相关、重叠感染率分别为66.67%、25.93%、29.63%。总病死率为68.52%,急性、亚急性及慢性妊娠中晚期重肝在病死率方面比较差异无显著性(P>0.05);中期、晚期妊娠重肝患者病死率比较差异无显著性(P>0.05)。存活组和死亡组在凝血酶原时间(PT)、血清总胆固醇(TC)及肝脏体积缩小等指标上差异有显著性(P<0.05)。病死率随着并发症增加而升高。胎儿总病死率48.15%,其中HBV感染相关的病死率占55.56%。结论引起妊娠中晚期重肝的病原体以HBV、HEV为主;该组病例的孕产妇及胎儿病死率高;其孕妇转归与PT、TC、肝脏体积大小及并发症相关;胎儿预后可能与HBV感染有关。
[Objective] To observe the impact of severe viral hepatitis on prognosis of both the pregnant women and the fetus during metaphase and late pregnancy. [Methods] Observe the infectious pathogens of severe viral hepatitis during metaphase and late pregnancy, and compare the mortality rate of different types and different stages of patients and the indexes and complications between the survival group and the death group, and the relation be- tween the fetal death and HBV infection. [Results] The prognosis is related to HBV and HEV infection, and the co-infection rate are 66.67%, 25.93% and 29.63% respectively, and the total mortality rate is 68.52%. There is no significant difference between the group of severe viral hepatitis cases during metaphase and the group of severe vi- ral hepatitis cases during late pregnancy （P 〉0.05）. There is significant difference between the survival group and the death group in prothrombin time （PT）, serum total cholesterol （TC）, and the size of liver （P 〈0.05）. More complica- tions induced more mortality rates. The total mortality rate of fetus is 48.15%, and 55.56% of which is related to HBV infection. [Conclusion] HBV and HEV are the most common infectious pathogens of severe viral hepatitis during metaphase and late pregnancy, and the mortality rate of both pregnant women and fetus is high in this group. The prognosis of pregnant women is related to PT, CHOL, the size of the liver and the number of complications. And the prognosis of fetus is related to HBV infection.
出处
《中国现代医学杂志》
CAS
CSCD
北大核心
2008年第13期1925-1927,共3页
China Journal of Modern Medicine
关键词
妊娠
重型病毒性肝炎
孕妇
胎儿
预后
pregnancy
severe viral hepatitis
pregnant women
fetus
prognosis
