妊娠期高血压合并乙型肝炎患者肝功能检测的价值及对新生儿并发症的影响

Detection of liver function in patients with gestational hypertension combined with hepatitis B and its effect on neonatal complications

目的探讨妊娠期高血压合并乙型肝炎患者肝功能检测的价值及对新生儿并发症影响。方法选取该院产科收治的正常妊娠者(A组)、单纯妊娠期高血压患者(B组)、患乙型肝炎的孕妇(C组)及妊娠高血压合并乙型肝炎孕妇(C组)各50例,检测并比较各组丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、总胆汁酸(TBA)、总胆红素(TBIL)的水平,分析肝功能指标与分娩结局的相关性。结果 A组患者肝功能水平正常,均低于B、C、D组患者(P<0.05)。D组新生儿低体质量、低血糖、胎儿窘迫、胎儿宫内生长受限的发生率均高于A组(P<0.05)。D组新生儿宫内HBV感染率高于C组新生儿(P<0.05)。经多元逐步回归分析得出,肝功能指标中的ALT、AST、TBA、TBIL水平与新生儿低体质量、低血糖、胎儿窘迫、胎儿宫内生长受限、新生儿宫内感染乙肝病毒间均呈正相关。结论妊娠期高血压合并乙肝患者可加重肝功损伤,肝功能损伤越严重的患者,其新生儿相关并发症的发生率越高。

Objective To investigate the value of liver function in patients with gestational hypertension combined with hepatitis B and the effect on neonatal complications.Methods Pregnant women with gestational hypertension and pregnant women with pregnancy-induced hypertension were randomly divided into group A,group B,group C and group D（n=50 in each group）.The levels of alanine aminotransferase（ALT）,aspartate aminotransferase（AST）,total bile acid（TBA）and total bilirubin（TBIL）were measured,and the correlation between liver function index and delivery outcome was analyzed.Results The levels of ALT,AST,TBA and TBIL in group A,B and C were significantly higher than those in group B,C and D.Neonatal complications among A,B,C groups showed no statistically significant difference（P0.05）.The incidence of intrauterine HBV infection in group D was significantly higher than that in group C（P0.05）.Multivariate stepwise regression analysis showed that ALT,AST,TBA and TBIL in liver function were associated with low birth weight,hypoglycemia,fetal distress,fetal intrauterine growth restriction,neonatal intrauterine HBV complications and there was significant positive correlation between them.Conclusion Pregnancy hypertensive patients with hepatitis B can increase liver injury and patients with more serious liver injury are more likely to have neonatal related complications.