妊娠合并慢性乙型肝炎患者的相关血液指标变化及临床意义

The changes and clinical significance of the blood related indexes in pregnant individuals with chronic type B hepatitis

目的探讨妊娠合并慢性乙型肝炎患者的相关血液学指标变化及其临床意义。方法分别采用速率法、比浊法、比色法、酶联免疫吸附实验及聚合酶链反应等方法,对妊娠期合并慢性乙型肝炎患者进行部分肝功能及凝血功能、乙肝两对半、HBV DNA的检测,并进行统计学分析。结果与对照组及无症状妊娠组比较,慢性乙肝妊娠组患者肝功能损害表现为谷丙转氨酶、谷草转氨酶、总胆红素及直接胆红素水平明显升高(P<0.05);清蛋白及凝血酶原活性降低,P<0.05。患者的病毒学特征表现为:HBeAg阳性和HBV DNA高滴度。结论妊娠合并慢性乙型肝炎的发生多集中于妊娠的中、晚期;临床类型以中、重度为主;HBeAg阳性和HBV DNA高滴度可作为妊娠期慢性乙型肝炎发生的预测指标。

Objective To explore the changes and clinical significance of the blood related indexes in pregnant patients with chronic hepatitis B virus infection. Methods Parts of liver and blood coagulation functions, serum markers of hepatitis B virus （HBV） ,and HBV DNA of all enrolled subjects were measured with rate method, turbidimetry, colorimetry, enzyme linked immu- nosorbent assay（ELISA） and polymerase chain reaction（PCR）. All data were analyzed statistically. Results Compared with healthy controls and pregnant individuals withHBV infection but without clinical symptom, ALT, AST, TBIL and DBIL increased significantly（P〈0.05） and the albumin and PTA decreased significantly（P〈0.05） in pregnant individual with chronic type B hepatitis. The positive rate of HBeAg and the titer of HBV DNA in pregnant individuals with chronic hepatitis B were higher than those in the other groups. Conclusion Chronic type B hepatitis combined with pregnancy mainly occurs during the middle to late stage of pregnancy,most of which are moderate or severe. Positive HBeAg and high titer of HBV DNA load can be used as parameters for the prediction of chronic type B hepatitis during pregnancy.