腺苷蛋氨酸肠溶片对乙型肝炎病毒感染孕妇孕早期轻度肝损伤的保护作用研究

Study on the protective effect of adenosylmethionine tablets on mild liver injury in early pregnancy with hepatitis B virus infection

目的:观察腺苷蛋氨酸肠溶片对乙型肝炎病毒(HBV)慢性感染孕妇孕早期轻度肝损伤的保护作用,分析其对妊娠结局的影响。方法:选取杭州市西溪医院(杭州市六医院)2017年1月至2018年12月就诊的孕早期肝功能轻度异常的慢性HBV感染孕妇46例为研究对象(治疗组),予腺苷蛋氨酸肠溶片口服治疗;选择同期未予药物治疗的肝功能轻度异常的慢性HBV感染孕妇53例为对照组,比较两组的总胆红素(TB)、丙氨酸氨基转移酶(ALT)、谷酰转氨酶(GGT)、凝血酶原时间(PT)、HBV-DNA定量水平,观察两组妊娠结局。结果:治疗2周后,治疗组ALT(80.85±30.55)U/L,低于对照组的(112.79±27.01)U/L(t=-4.26,P<0.05);GGT(30.81±24.26)U/L,低于对照组的(44.20±24.89)U/L(t=-2.07,P<0.05);治疗组肝功能复常时间为(6.43±2.06)周,短于对照组的(10.21±3.05)周,差异有统计学意义(t=-5.66,P<0.05)。治疗组孕期肝功能波动率为21.4%(6/28),低于对照组的37.0%(10/37),但差异无统计学意义(χ2=0.27,P=0.60);两组分娩孕周、胎儿窘迫发生率、新生儿出生体质量等差异均无统计学意义(均P>0.05)。结论:腺苷蛋氨酸肠溶片可改善慢性HBV感染孕妇肝功能,有助于控制病情,孕早期用药对妊娠结局无明显不良影响。

Objective To study the protective effect of adenosylmethionine tablet on mild liver injury in early pregnancy with chronic hepatitis B virus(HBV)infection and observe the ending of pregnancy.Methods From January 2017 to December 2018,46 cases of chronic HBV infected pregnant women with mild abnormal liver function in early pregnancy who were treated in Hangzhou Xixi Hospital were selected as treatment group.Another 53 cases of chronic HBV infected pregnant women with the similar situation of liver function without drug treatment were selected as control group during the same period.The levels of total bilirubin(TB),alanine aminotransferase(ALT),glutamine transaminase(GGT),prothrombin time(PT)and HBV DNA quantification(HBVDNA)were compared between the two groups,and the pregnancy outcome in the two groups was observed.Results After treatment for 2 weeks,the ALT and GGT levels of the treatment group were significantly lower than those of the control group[(80.85±30.55)U/L vs.(112.79±27.01)U/L(t=-4.26,P<0.05);(30.81±24.26)U/L vs.(44.20±24.89)U/L(t=-2.07,P<0.05)].The recovery time of liver function in the treatment group[(6.43±2.06)weeks]was significantly shorter than that in the control group[(10.21±3.05)weeks](t=-5.66,P<0.05).The fluctuation rate of liver function in the treatment group[21.4%(6/28)]was lower than that in the control group[37.0%(10/37)],but there was no statistically significant difference between the two groups(χ2=0.27,P=0.60).There were no statistically significant differences between the two groups in the gestational age,fetal distress rate and birth weight(all P>0.05).Conclusion Adenosylmethionine tablets can improve the liver function of pregnant women with chronic HBV infection,which is helpful for the treatment of liver dysfunction in early pregnancy.The use of adenosylmethionine tablets in early pregnancy has no obvious adverse effect on pregnancy outcome.