HBV携带孕妇妊娠晚期HBV DNA载量及产褥期生活方式对产后转氨酶的影响

Effects of HBV-DNA load during late pregnancy and postpartum lifestyle of pregnant women carried HBV on ALT and AST levels after delivery

目的探讨携带HBV孕妇在妊娠晚期的HBV DNA载量、产褥期每日睡眠时间、产褥期乙醇摄入对其产后转氨酶的影响。方法随机选择门诊产前检查HBsAg阳性的152例孕妇(研究组)、HBsAg阴性的112名孕妇(对照组),检测研究组妊娠晚期HBV DNA载量,测定2组产妇产后42 d时ALT和AST水平。对2组产妇在产褥期内的睡眠时间、饮食结构进行随访,研究组中产褥期有摄入乙醇者设为A组,无摄入乙醇者设为B组,对照组相应设为C、D组;另将研究组中产褥期睡眠时间少于8 h/d者设为a组,达到或超过8 h/d者设为b组,对照组中相应设为c、d组。研究组中,妊娠晚期HBV-DNA载量异常者设为E组,正常者设为F组。比较各亚组孕妇产后42 d转氨酶水平。结果 A组孕妇产后AST异常率明显高于B、C、D组(P<0.01)。a组孕妇产后ALT、AST异常率明显高于c、d组(P<0.01),但与b组比较差异无统计学意义(P>0.05)。E组孕妇产后ALT、AST异常率明显高于F组(P均<0.05)。结论妊娠晚期HBV DNA载量异常、产褥期摄入乙醇的携带HBV者,其转氨酶在产后容易出现异常。

Objective To investigate the effects of HBV-DNA load during late pregnancy, daily sleep time and alcohol intake on ALT and AST levels after postpartum. Methods In total, 152 pregnant women with HBsAg （ ＋ ） and 112 counterparts with HBsAg （-） were randomly selected from the outpatient and allocated into the experimental and control groups. HBV-DNA levels during late pregnancy in the experi- mental group were detected. ALT and AST levels at 42 d after postpartum were measured and statistically com- pared between two groups. Daily sleep time and dietary components in two groups were followed up. Partici- pants in the experimental group were further divided into subgroups A （ alcohol intake） and B （none） and cor- responding subgroups C and D were established in the control group. In the experimental group, those with postpartum daily sleep time 〈 8 h/d were assigned to subgroup a and 〉 8 h/d to subgroup b, and correspond- ing subgroups c and d were assigned in the control group. Women with abnormal HBV-DNA load during late pregnancy in the experimental group were allocated to subgroup E and those with normal HBV-DNA load to subgroup F. ALT and AST levels at 42 d after postpartum was compared among different subgroups. Results The incidence of abnormal AST levels in subgroup A was significantly increased than those in subgroups B, C and D （all P 〈0. 01 ）. The incidence of abnormal ALT and AST levels in subgroup a was significantly higher than those in subgroups c and d （ both P 〈 0. 01 ） , but no statistical significance was observed with that in subgroup b （P 〉 0. 05）. The incidence of abnormal ALT and AST levels in subgroup E was significantly increased than that in subgroup F （both P 〈 0. 05）. Conclusion The women carriying HBV with abnormal HBV-DNA load in late pregnancy, postpartum alcohol intake may present with postpartum abnormal ALT and AST levels.