妊娠期慢性乙型肝炎病毒携带者病毒载量与肝功能及妊娠期并发症的相关性

Study on the correlation between viral load of chronic hepatitis B virus infection and liver function and pregnancy complications

目的分析妊娠期慢性乙型肝炎病毒携带者病毒载量与孕妇肝功能、妊娠并发症的相关性。方法将本院2015年1月—12月间在本院住院并于本院分娩的携带慢性乙型肝炎病毒(HBV)的86例孕妇作为本次研究对象,于住院期间分娩前测定孕妇HBV脱氧核糖核酸(HBV-DNA)定量,依据HBV-DNA定量测定结果将全部患者分为阴性组与阳性组,分别对比2组患者的临床资料、肝功能、妊娠并发症发生率及母婴结局;分析HBV-DNA载量与孕妇妊娠期肝功能及妊娠并发症的相关性。结果 2组孕妇的年龄、BMI、孕次与产次均无差异,P>0.05;阴性组患者妊娠期肝功能指标优于阳性组,P<0.01。阴性组中羊水量异常(偏多或偏少)发生率高于阳性组,P<0.05;其他妊娠期并发症发生率2组均未见差异,P>0.05。2组母婴结局均未见统计学差异,P>0.05。HBV载量与ALT肝功能指标均呈正相关,0<r<1,说明HBV-DNA越高则ALT越高,孕妇的肝功能越差。HBV载量与并发症发生间基本不相关,|r|<0.3,P>0.05。结论慢性乙型肝炎病毒携带者妊娠期时随着病毒载量的升高,孕妇的肝功能有所下降仍可维持在正常标准,但与妊娠并发症的发生无相关性;提示对HBV-DNA阳性的孕妇给予密切监护,通过临床常规对症治疗能够保证母婴安全。

Objective To analyze the correlation between viral load of chronic hepatitis B virus infection and liver function and pregnancy complications. Methods We selected 86 cases of pregnant women with chronic hepatitis B virus（ HBV） in our hospital from January 2015 to December 2015 as the research objects,and then during the hospitalization to test the quality of the HBV deoxyribonucleic acid（ HBV-DNA） for them before delivery. According to the HBV-DNA quantitative results,all patients were divided into low dosage group and high dosage group,and then the clinical data,liver function,the incidence rate of pregnancy complications and the outcomes of the two groups were compared; at last we analyzed the correlation among the HBV-DNA load,liver function of pregnant women during pregnancy and pregnancy complications. Results There was no difference between the two groups of pregnant women in the age,BMI,pregnancy and birth time,P〉0. 05; the low dose group was better than the high dose group in the liver function index during the pregnancy,P 0. 01. The incidence of abnormal amniotic fluid volume（ more or less） in the low dose group was higher than that in the high dose group,P〉0. 05; there was no significant difference between the two groups in the incidence of other complications,P〈0. 05. There was no statistical difference between the two groups in maternal and neonatal outcomes,P〈0. 05. The HBV load was positively correlated with the two liver function indexes ALT,0 r 1,indicating that the higher the HBV-DNA,the higher the ALT,the worse the liver function of the pregnant women. There was no correlation between HBV load and complications, ｜ r ｜〈 0. 3,P〉0. 05. Conclusion Chronic hepatitis B virus carriers during pregnancy with increasing viral load,liver function of pregnant women declined to maintain in normal level,but not associated with pregnancy complications;that of HBV-DNA positive pregnant women given close monitoring of disease through clinical routine treatment can ensure the safety of mother and child.