摘要
目的:探讨慢性乙型肝炎病毒(HBV)感染对妊娠期糖尿病(GDM)及妊娠结局的影响,为妊娠期产妇慢性HBV感染预防提供参考。方法:回顾性分析2015年2月-2017年2月在我院住院分娩的2615例慢性HBV感染产妇的临床病历资料,根据《慢性乙型肝炎防治指南》(2015年版)诊断标准,将所有产妇分为4组:慢性HBV携带者(A组)1128例、乙型肝炎e抗原(HBe Ag)阳性慢性乙型肝炎(B组)406例、HBe Ag阴性慢性乙型肝炎(C组)307例、非活动性乙型肝炎表面抗原(HBs Ag)携带者(D组)774例,并收集同期入院的823例HBV阴性产妇为对照组(E组)。比较各组的GDM发生率及不良妊娠结局发生率。结果:2615例慢性HBV感染产妇中,共发生GDM 866例,发生率为33.12%。B组与C组GDM发生率分别为38.92%、37.46%,均大于E组的30.74%(P<0.05)。A组、B组、C组的妊娠期高血压疾病(PIH)发生率分别为7.98%、8.87%、9.77%,均高于E组的3.52%(P<0.05);A组、B组、C组及早产发生率分别为3.10%、3.94%、4.56%,均高于E组的0.49%(P<0.05)。C组的新生儿窒息发生率为1.63%,高于E组的0.36%(P<0.05)。结论:产妇慢性HBV感染若合并肝功能受损或肝组织学病变,可能增加GDM的发生率,若HBV病毒复制活跃,可能导致PIH及早产发生风险增加。
Objective： To investigate the influence of chronic hepatitis B virus（HBV） infection on gestational diabetes mellitus（GDM） and pregnancy outcome so as to provide reference for the prevention of chronic HBV infection in puerpera during pregnancy.Methods： The clinical data of 2615 puerpera with chronic HBV infection who were hospitalized delivery in our hospital from February2015 to February 2017 were performed retrospective analysis. According to the diagnostic criteria in Guidelines for Prevention and Treatment of Chronic Hepatitis B（2015 Edition）,the puerpera were divided into four groups： 1128 cases of chronic HBV carriers（group A）,406 cases of chronic hepatitis B with HBe Ag-positive（group B）,307 cases of chronic hepatitis B with HBe Ag-negative（group C）,774 cases of inactive hepatitis B with HBs Ag carriers（group D）,and 823 cases of puerpera with HBV-negative admitted to hospital in the same period were selected as the control group（group E）. Then the incidence difference of GDM and pregnancy outcomes were compared between those five groups. Results： 866 cases of GDM occurred in 2615 puerpera with chronic HBV infection,the incidence rate was 33.12%. And the GDM incidence rates of group B and group C were 38.92%,37.46% respectively,which were higher than30.74% of group E（P〈0.05）. The incidence rate of pregnancy induced hypertension（PIH） of group A,group B and group C were 7.98%,8.87%,9.77% respectively,which were higher than 3.52% of group E（P〈0.05）. The incidence rate of premature delivery of group A,group B and group C were 3.10%,3.94%,4.56% respectively,which were higher than 0.49% of group E（P〈0.05）. The incidence of neonatal asphyxia of group C was 1.63%,which was higher than 0.36% of group E（P〈0.05）. Conclusion： Puerpera with chronic HBV infection have higher risk in the GDM incidence when complicated with liver dysfunction or liver histological lesions,and when their HPV replication is active,it could increased the risk of PIH and preterm birth.
作者
何煜暐
祁红英
韩彦渊
马晓梅
秦凤
HE Yu-wei;QI Hong-ying;HAN Yan-yuan;MA Xiao-mei;QIN Feng(Department of Endocrinology,Affiliated Hospital of Qinghai University,Xining,Qinghai,810001,China)
出处
《现代生物医学进展》
CAS
2018年第16期3179-3182,共4页
Progress in Modern Biomedicine
基金
2017年青海省卫计委医药卫生指导性课题(2017-wjzdx-68)
青海大学附属医院中青年科研基金项目(ASRF-2010-17)
关键词
慢性
乙型肝炎病毒
妊娠期糖尿病
妊娠结局
感染
产妇
Chronic
Hepatitis B virus
Gestational diabetes mellitus
Pregnancy outcomes
Infection
Puerpera
