摘要
目的分析妊娠肝内胆汁淤积症(ICP)合并乙型肝炎病毒(HBV)感染对孕妇甲状腺功能指标及围产结局的影响。方法回顾性分析2017年6月至2019年4月海南省妇女儿童医学中心诊治的150例ICP患者临床资料,按照是否合并HBV感染将其分为研究组(104例,合并HBV),对照组(46例,未合并HBV),对比两组甲状腺功能指标[游离三碘甲状腺原氨酸(FT3)、游离型甲状腺素(FT4)、促甲状腺激素(TSH)、三碘甲状腺原氨酸(T3)、甲状腺素(T4)]、围产结局。结果研究组T3、T4、FT3水平与对照组比较,差异无统计学意义(P>0.05);相比对照组,研究组TSH水平较低,FT4水平较高,差异有统计学意义(P<0.05)。研究组剖宫产、早产、妊娠高血压、产后出血及新生儿窒息、低体重儿、胎儿窘迫发生率均比对照组高,差异有统计学意义(P<0.05)。结论ICP合并HBV感染易诱发产妇妊娠期甲状腺功能亢进,增加不良妊娠结局的发生风险,故应密切监测患者甲状腺功能及病情,积极采取防治措施,以改善母婴结局。
Objective To analyze the effect of intrahepatic cholestasis of pregnancy(ICP)combined with hepatitis B virus(HBV)infection during pregnancy on the thyroid function and perinatal outcome in pregnant women.Methods The clinical data of 150 pregnant women with ICP from June 2017 to April 2019 were retrospectively analyzed.According to whether they were complicated with HBV or not,they were divided into control group(46 cases,without HBV)and the research group(104 cases,with HBV).The thyroid function[free triiodothyronine(FT 3),Free thyroxine(FT 4),thyroid stimulating hormone(TSH),triiodothyronine(T 3),thyroxine(T 4)],and perinatal outcome were compared between the two groups.Results The levels of serum TSH in research group was lower than that in the control group,and FT 4 was higher than that in control group,all with statistically significant differences(P<0.05).The incidence of cesarean section,premature delivery,pregnancy induced hypertension,postpartum hemorrhage,neonatal asphyxia,low birth weight and fetal distress in research group was higher than those in the control group,all with statistically significant differences(P<0.05).Conclusions ICP complicated with HBV infection can easily induce hyperthyroidism during pregnancy and increase the risk of ad-verse pregnancy outcome.Therefore,thyroid function and condition of patients should be closely monitored and preventive measures should be taken actively to improve maternal and infant outcomes.
作者
张芳芳
ZHANG Fangfang(Department of Obstetrics and Gynecology,Hainan Women's and Children's Medical Center,Haikou 570000,Hainan,China)
出处
《中国性科学》
2020年第9期58-61,共4页
Chinese Journal of Human Sexuality
关键词
妊娠肝内胆汁淤积症
乙型肝炎病毒
甲状腺功能
围产结局
Intrahepatic cholestasis of pregnancy(ICP)
Hepatitis B virus(HBV)
Thyroid function
Perinatal outcome
