妊娠合并乙型肝炎病毒感染患者血清铁代谢指标变化

The changes of serum iron markers in pregnant women with hepatitis B virus infection

目的探讨乙型肝炎病毒(HBV)感染对孕妇血清铁代谢指标的影响。方法检测188例HBV感染孕妇及157例健康孕妇血清铁、血清铁蛋白、转铁蛋白、病毒载量、丙氨酸氨基转移酶(ALT)和天门冬氨酸氨基转移酶(AST)水平并进行比较。结果HBV感染孕妇血清铁蛋白水平明显高于同孕期健康孕妇(Z=-1.72,P=0.04;Z=-2.33,P=0.01;Z=-4.42,P=0.01),HBV感染孕妇孕中期与孕晚期血清转铁蛋白水平明显低于同孕期健康孕妇(Z=-3.26,P<0.01;Z=-2.25,P=0.01),ALT、AST阳性的HBV感染孕妇血清铁蛋白水平明显高于ALT、AST阴性孕妇(ALT:P=0.01;AST:P=0.02),而健康孕妇变化不明显。结论 HBV感染孕妇存在铁代谢失调,针对此类孕妇应及时监测血清铁代谢指标水平,从而指导孕妇妊娠期合理补铁。

Objective To investigate the effect of hepatitis B virus(HBV)infection on serum iron markers in pregnant women.Methods A total of 188 pregnant women with HBV infection and 157 normal pregnant women were recruited in this study.Serum levels of iron,ferritin,transferrin,HBV DNA,alanine aminotransferase(ALT)and aspartate aminotransferase(AST)were measured and compared.Results At the same stage of pregnancy,the serum ferritin level in pregnant women with HBV infection was higher than that of normal pregnant women(Z=-1.72,P=0.04;Z=-2.33,P=0.01;Z=-4.42,P=0.01),while the serum transferrin concentration increased in normal pregnant women in the second and third trimesters,and the differences between the two groups were statistically significant(Z=-3.26,P<0.01;Z=-2.25,P=0.01).In pregnant women with HBV infection,the serum ferritin levels in patients with positive results of ALT and AST were higher than those in patients with negative results(ALT:P=0.01;AST:P=0.02),however,there was no change in healthy pregnant women.Conclusion There is iron metabolism imbalance in pregnant women with HBV infection.We should monitor serum iron markers to guide pregnant women for appropriate iron supplementation in gestation period.