孕妇显性或隐匿性乙型肝炎病毒感染肝功能指标比较研究

Comparison of liver functional indices among pregnant women infected with overt or occult hepatitis B virus

目的探讨妊娠合并显性乙型肝炎病毒(hepatitis B virus,HBV)或隐匿性乙型肝炎病毒感染(occult hepatitis B virus infection,OBI)对孕妇肝功能指标的影响。方法采用以医院为基础的住院孕妇队列研究。以活产分娩且肝功能检查资料完善的2 195例孕妇为研究对象,收集其临产前血清,检测乙型肝炎病毒表面抗原(hepatitis B virus surface antigens,HBs Ag)和HBV S/pre S/C片段,分析并比较显性HBV感染、OBI与非HBV感染孕妇的肝功能指标的差异。结果显性HBV感染孕妇的ALT、TBAS水平显著高于非HBV感染孕妇,而TP和ALB则明显降低,GLB在3组孕妇中总体差异有统计学意义(P<0.05),AST、ALP、GGT、TBIL、DBIL在3组孕妇中总体差异无统计学意义(P>0.05)。结论显性HBV感染的活产孕妇妊娠期间ALT、TBAS、TP、ALB指标值异于非HBV感染活产孕妇,未发现OBI活产孕妇肝功能指标与显性HBV、非HBV感染活产孕妇的差异。提示临床应加强对显性HBV感染孕妇的肝功能监测,减少不良妊娠结局发生,促进母婴健康。

Objective To explore the differences of liver functional indices between overt hepatitis B virus（ HBV） and occult HBV infection（ OBI） in pregnant women. Methods Based on a hospital cohort,2 195 pregnant women who gave live birth and performed complete liver function tests were collected as the research subjects. Blood samples were collected and detected for HBV surface antigen（ HBs Ag） and HBV S/pre S/C fragments. The comparison of liver functional indices among overt HBV,occult HBV and non-HBV in pregnant women were performed. Results Overt HBV infected participants had higher ALT and TBAS levels,and lower TP and ALB,compared with non-HBV infected participants. The overall difference of GLB in the 3 groups was statistically significant（ P 〈 0. 05）. There was no statistical significance on the difference of AST,ALP,GGT,TBIL,DBIL among the three groups（ P 〉 0. 05）. Conclusion Hospitalized pregnant women with overt HBV infection have different ALT,TBAS,TP,ALB levels from non-HBV infected pregnant women. No OBI-specific difference of liver functional indices are observed. Routinely monitoring of liver function test should be recommended to pregnant women with overt HBV infection to minimize adverse pregnancy outcomes and promote maternal and child health.