摘要
目的：探讨对免疫耐受期乙型肝炎病毒（HBV）感染女性孕期进行肝功能监测的临床意义。方法：回顾性分析该院妇产科2013年3月~2014年3月进行产检、生育并完成产后随访的免疫耐受期HBV感染女性共80例,根据产后肝功能分为肝功能异常组和正常组,每组40例,对比两组孕妇肝功能、HBV DNA水平、分娩方式、妊娠并发症发生率和产后婴儿HBs Ag和HBV DNA阳性率。结果：肝功能异常组的孕期平均丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）、血清总胆红素（TBIL）、直接胆红素（DBIL）和孕28周HBV DNA均显著高于肝功能正常组,P〈0.01。两组孕妇的分娩方式无统计学差异,P〉0.05;肝功能异常组的妊娠并发症发生率显著高于对照组,P〈0.05。肝功能异常组的产后婴儿HBs Ag和HBV DNA阳性率显著高于肝功能正常组,χ2=5.000 0,P〈0.05。结论：免疫耐受期HBV感染女性的孕期肝功能和病毒复制监测对其产后肝功能、妊娠结局和婴儿预后有重要影响,应加强对此类女性的孕期肝功能监测,必要时予以抗病毒治疗。
Objective： To explore the clinical significance of liver function monitoring during pregnancy among HBV- infected women in immune tolerance phase. Methods： Eighty HBV- infected women in immune tolerance phase who received prenatal examination,gave birth to their babies and received postpartum follow- up in the hospital from March 2013 to March 2014 were analyzed retrospectively,then they were divided into normal liver function group and abnormal liver function group according to liver function,40 women in each group. Liver functions,HBV DNA levels,delivery modes,morbidities of pregnancy complications,postpartum infantile HBs Ag and HBV DNA positive rates in the two groups were compared. Results： The mean levels of alanine aminotransferase（ ALT）,aspartate transaminase（ AST）,serum total bilirubin,direct bilirubin and HBV DNA during the 28 th gestational week in abnormal liver function group were statistically significantly higher than those in normal liver function group（ P 0. 01）. There was no statistically significant difference in delivery modes between the two groups（ P 0. 05）; the morbidity of pregnancy complications in abnormal liver function group was statistically significantly higher than that in normal liver function group（ P 0. 05）. Postpartum infantile HBs Ag and HBV DNA positive rate in abnormal liver function group was statistically significantly higher than that in normal liver function group（ χ2= 5. 000 0,P 0. 05）. Conclusion： Liver function and HBV replication monitoring among HBV- infected women in immune tolerance phase have important impacts on postpartum liver function,pregnancy outcome and infantile prognosis,liver function monitoring in immune tolerance phase should be strengthened for HBV- infected women,antiviral treatment can be given if necessary.
出处
《中国妇幼保健》
CAS
2015年第8期1167-1169,共3页
Maternal and Child Health Care of China
关键词
免疫耐受期
HBV感染女性
孕期
肝功能
Immune tolerance phase
HBV-infected woman
Gestational period
Liver function
