慢性HBV感染女性妊娠期血糖水平与妊娠不良结局

Blood glucose level during pregnancy and adverse pregnancy outcomes of pregnant women with chronic hepatitis B virus infection

目的:探究慢性乙型肝炎病毒(HBV)感染女性妊娠期血糖与妊娠不良结局。方法:选择本院2021年1月-2023年11月收治的256例孕妇,将无HBV感染孕妇(对照组106例)、仅HBV携带无需抗病毒治疗孕妇(感染组100例)、慢性乙肝接受抗病毒治疗孕妇(治疗组50例),测定血糖指标并评估妊娠结局,受试者工作特征曲线(ROC)分析血糖指标预测HBV感染不良妊娠结局价值。结果:孕妇餐后2h血糖、空腹血糖与糖化血红蛋白水平对照组、感染组、治疗组依次升高,感染组和治疗组母体与新生儿并发症发生率高于对照组(P<0.05)。治疗组中妊娠结局不良患者餐后2h血糖、空腹血糖与糖化血红蛋白水平均高于妊娠结局良好患者(P<0.05)。ROC分析显示,餐后2h血糖、空腹血糖与糖化血红蛋白预测HBV感染患者妊娠不良结局的曲线下面积分别为0.832、0.753,0.784,各指标联合预测的曲线下面积为0.925。结论:HBV感染孕妇血糖水平异常升高,其且与患者妊娠不良结局发生有关,血糖指标联合检测预测HBV感染妊娠不良结局价值较好。

Objective:To explore the blood glucose level during pregnancy and the adverse pregnancy outcomes of pregnant women with chronic hepatitis B virus(HBV)infection.Methods:256 pregnant women admitted to the hospital were selected as the study objects from January 2021 to November 2023.These women were divided into group A(106 women withoutHBVinfection),group B(100 women with HBV infection and without antiviral therapy)and group C(50 women with chronicHBV infection and antiviral therapy).The levels of the blood glucose indexes of the women in the three groups were measured,and the pregnancy outcomes of the women in the three groups were evaluated.The values of the blood glucose indexes levels of the women with chronicHBV infection for predicting their adverse preg-nancy outcomes were analyzed by receiver operator characteristic(ROC)curve.Results:The levels of 2h postprandial blood glucose,fasting blood glucose and glycosylated hemoglobin of the women in group A,in group Band in group C had increased gradually.The incidences of the maternal and neonatal complications in group B and in group C were significantly higher than those of the women in group A(P<0.05).In group C,the levels of 2h postprandial blood glucose,fasting blood glucose and glycosylated hemoglobin of the women with adverse pregnancy outcomes were significantly higher than those of the women with normal pregnancy outcomes(P<0.05).ROC analysis showed that the area under the curve of the levels of 2h postprandial blood glucose,fasting blood glucose and glycosylated hemoglobin of the women with HBV infection for predicting their adverse pregnancy outcomes were 0.832,0.753 and 0.784,respectively,and the area under the curve of the combined levels of 2h postprandial blood glucose,fasting blood glucose and glycosylated hemoglobin of the women with HBV infection for predicting their adverse pregnancy outcomes was 0.925.Conclusion:The blood glucose level of the pregnant women with HBV infection increases abnormally,and which is related to the occurrence of their adverse pregnancy outcomes.The values of the combined levels of the blood glucose indexes of the women for predicting their adverse pregnancy outcomes is better.