摘要
目的分析慢性乙型肝炎患者并发妊娠期肝内胆汁淤积症(ICP)的危险因素。方法选取于2014年1月~2016年4月期间在我院行孕期检查的慢性乙型肝炎孕妇258例,其中36例孕妇并发ICP。将36例ICP患者和222例未发生ICP患者进行相关因素的单因素分析,再经多因素Logistic回归分析得出慢性乙型肝炎孕妇并发ICP的独立危险因素。结果在258例慢性乙型肝炎孕妇中,并发ICP36例(14.0%);ICP组孕妇有ICP家族史、高血压、尿蛋白阳性和高雌激素的比例分别为13.9%、22.2%、36.1%和58.3%,显著高于非ICP组(1.8%、8.6%、5.9%和7.7%,P<0.05);ICP组孕妇血清谷丙转氨酶(ALT)、碱性磷酸酶(ALP)、血尿素氮(BUN)、总胆红素(TBIL)和总胆汁酸(TBA)水平分别为(119.2±10.2 U/L、139.1±15.4 U/L、5.5±0.5 mmol/L、48.9±6.5μmol/L和15.5±2.0μmol/L),均显著高于非ICP组【(78.3±8.3 U/L、98.5±14.2 U/L、4.6±0.4 mmol/L、32.0±5.1μmol/L和9.1±1.5μmol/L),P<0.05】;ICP组孕妇血清纤维蛋白原(FIB)水平为(2.1±0.6)g/L,显著低于非ICP组【(2.9±0.5)g/L,P<0.05】;ICP组孕妇年龄、初次妊娠比例、体质指数(BMI)和糖尿病比例分别为(28.6±4.1岁、61.1%、25.9±1.2 kg/m2和13.9%),与非ICP组(27.8±4.2岁、59.0%、25.5±1.1 kg/m^2和11.3%)相比,差异均无统计学意义(均P>0.05);多因素分析结果显示,ICP家族史、高血压、尿蛋白阳性和高雌激素为慢性乙型肝炎孕妇发生ICP的独立危险因素(均P<0.05)。结论有ICP家族史、高血压、尿蛋白阳性和雌激素高水平均会增加慢性乙型肝炎孕妇发生ICP的风险。
Objective To analyze the risk factors of intrahepatic cholestasis of pregnancy （ICP） in patients with hepatitis B. Methods 258 pregnant women with hepatitis B between January 2014 and April 2016 were included in this study,and 36 cases out of them were complicated with ICP. 36 patients with ICP and 222 patients without ICP were analyzed by univariate analysis,and then multivariate Logistic regression analysis was applied to get the independent risk factors of ICP. Results The percentage of ICP was 14.0% in this series;the family history of ICP,hypertension,urine protein positive and high estrogen levels in ICP group were 13.9%, 22.2%,36.1% and 58.3%,much higher than in non-ICP group （1.8%,8.6%,5.9% and 7.7%,respectively,all P〈0.05）;serum alanine aminotransferase（ALT）,alkaline phosphatase（ALP）,blood urea nitrogen（BUN）,total bilirubin （TBIL） and total bile acid （TBA） levels in ICP group were （119.2±10.2 U/L,139.1±15.4 U/L,5.5±0.5 mmol/L, 48.9±6.5 μmol/L and 15.5±2.0μmol/L,much higher than in non-ICP group （78.3±8.3 U/L,98.5±14.2 U/L,4.6±0.4 mmol/L,32.0±5.1 μmol/L and 9.1±1.5 μmol/L,all P〈0.05）;blood fibrinogen level in ICP group was （2.1±0.6）g/L, much lower than in non-ICP group [（2.9 ±0.5）g/L,P〈0.05];age,proportion of first pregnancy,body mass index （BMI） and proportion of diabetes in ICP group were 28.6±4.1 year-old,61.1%,25.9±1.2 kg/m2 and 13.9%,and in non-ICP group were 27.8 ±4.2 year-old,59.0%,25.5 ±1.1 kg/m2 and 11.3%,all without statistically significant differences （P＆gt;0.05）;multivariate analysis showed that ICP family history,hypertension,urine protein positive and high estrogen levels were the independent risk factors of ICP in pregnant women with hepatitis B. Conclusion The ICP family history,hypertension,urine protein positive and high estrogen levels will increase the risk of ICP occurrence in pregnant women with hepatitis B.
出处
《实用肝脏病杂志》
CAS
2017年第3期280-283,共4页
Journal of Practical Hepatology
