乙肝感染孕妇伴发妊娠期肝内胆汁淤积症的风险因素分析

Risk factors of intrahepatic cholestasis of pregnancy in pregnant women with hepatitis B infection

目的分析乙肝感染孕妇伴发妊娠期肝内胆汁淤积症(ICP)的风险因素。方法收集乙型肝炎病毒(HBV)感染孕妇512例,根据是否存在ICP分为伴发ICP组73例和无ICP组439例。对两组的相关因素进行单因素分析和多因素分析。结果伴发ICP组有ICP家族史、高雌激素水平、机体免疫失调及硒摄入不足明显高于无ICP组,差异有统计学意义(P<0.05)。有ICP家族史、高雌激素水平、机体免疫失调及硒摄入不足是乙感感染孕妇伴发ICP的独立危险因素。结论临床上对HBV感染的孕妇应重视ICP的相关因素分析,门诊就诊时详细询问病史,密切监测雌激素、机体免疫状态及硒摄入情况,以避免严重的不良妊娠结局。

[Objective] To analyze the risk factors of intrahepatic cholestasis of pregnancy （ICP） in pregnant women with hepatitis B infection. [Methods] A total of 512 pregnant women with hepatitis B virus （HBV） were collected and divided into ICP group （n =73） and non-ICP group （n =439） according to the presence of ICE Univariate analysis and multivariate analysis were performed on the related factors of the two groups. [Results] ICP family history, high estrogen levels, immune disorders, insufficient selenium intake was more obvious in ICP group than in the non-ICP group, and the difference was significant （P 〈0.05）. ICP family history, high estrogen level, immune imbalance and selenium deficiency were independent risk factors for ICP in pregnant women with B infection. [Conclusion] Attention should be paid to the analysis of related factors of ICP in HBV infected pregnant women in clinic, the medical history should be inquired in detail when patients were visiting a doctor in outpatient clinic, estrogen and immune status and selenium intake should be closely monitored to avoid serious adverse pregnancy outcomes.