Analysis of clinical characteristics of viral hepatitis in pregnant women
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摘要: 目的了解妊娠期病毒性肝炎的临床特点。方法回顾性分析2009年1月至2013年3月于广州市第八人民医院因病毒性肝炎住院的77例妊娠妇女的临床资料,分析肝炎病因、血清病毒学特点、肝损害程度与孕期的相关性。计量资料的组间比较采用Kruskal-Wallis H检验。结果病因:乙型肝炎多见,共72例(93.51%),有10.27%患者感染甲、乙或戊型肝炎病毒所致急性病毒性肝炎;肝损害程度:中度肝损害64例(83.12%),重度肝损害7例(9.09%),肝衰竭3例(3.90%);肝炎发作时孕期:妊娠早期16例(20.78%),妊娠中期49例(63.64%),妊娠晚期12例(15.58%);肝功能指标:总胆汁酸(TBA)、TBil、白蛋白(Alb)、ALT、AST、凝血酶原活动度(PTA)在HBeAg阳性和阴性患者间,以及在HBV DNA>106IU/ml和HBV DNA≤106IU/ml患者间差异均无统计学意义(P>0.05)。结论妊娠期病毒性肝炎主要由HBV引起,多数引起中度肝损害,重度肝损害或肝衰竭常发生于妊娠中晚期,因此育龄妇女妊娠期须注意防治慢性乙型肝炎。Abstract: Objective To study the clinical characteristics of viral hepatitis in pregnancy. Methods A retrospective analysis was performed on 77 pregnant women with viral hepatitis who were admitted to our hospital from January 2009 to March 2013. Cause of hepatitis, serologic and virologic markers, degree of liver damage, and association with the stage of pregnancy were analyzed. Comparison of continuous data between groups was made by Kruskal- Wallis H test. Results The main cause of viral hepatitis in pregnancy was HBV infection (72cases, 93. 51%) , and 10. 27% of patients were infected with hepatitis A, B or E virus. Moderate liver damage was detected in 64 patients (83.12%) , severe liver damage in 7 patients (9.09%) , and liver failure in 3 patients (3.90%) . Sixteen patients (20.78%) were diagnosed with hepatitis in the first trimester of pregnancy, 49 (63. 64%) in the second trimester, and 12 (15. 58%) in the third trimester.Liver function indices, including total bile acid (TBA) , total bilirubin (TBil) , albumin ( Alb) , alanine aminotransferase ( ALT) , aspartate transaminase (AST) , and prothrombin activity (PTA) , were compared between HBeAg ( +) and HBeAg (-) patients and between patients with HBV DNA > 106 IU /ml and ≤106IU /ml, and no significant differences were found in either comparison (P > 0. 05) . Conclusion Viral hepatitis in pregnancy is mainly caused by infection with hepatitis B virus. Liver damage is mostly moderate and severe liver damage and liver failure often occur in the middle or late stage of pregnancy. This study indicates that pregnant women should take precautions and active treatment for chronic hepatitis B.
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[1] Chinese Society of Hepatology and Chinese Society of Infectious Diseases, Chinese Medical Association.The guideline of prevention and treatment for chronic hepatitis B (2010 version) [J].Chin J Infect Dis, 2011, 39 (2) :65-80. (in Chinese) 中华医学会肝病学分会, 中华医学会感染病学分会.慢性乙型肝炎防治指南 (2010年版) [J].中华传染病杂志, 2011, 39 (2) :65-80. [2]YANG SJ, REN H.Infectious diseases[M].7th ed.Beijing:People's Medical Publishing House, 2008:23-51. (in Chinese) 杨绍基, 任红.传染病学[M].7版.北京:人民卫生出版社, 2008:23-51. [3]SHAO MM, LI P, QIAN Y, et al.Detection of hepatitis B virus in pregnant women[J].Chin J Birth Health Heredity, 2006, 14 (5) :82. (in Chinese) 邵明明, 李萍, 钱燕, 等.孕妇乙肝病毒检测分析[J].中国优生与遗传杂志, 2006, 14 (5) :82. [4] YOU Y, XING AY, ZHOU YB, et al.Hepatitis B virus infection in pregnant women:an investigation of 5361 cases[J].J Chin Mod Gynecol Obstetr, 2004, 1 (1) :85-86. (in Chinese) 游泳, 邢爱耘, 周永碧, 等.孕妇乙型肝炎病毒感染5361例情况调查[J].中华现代妇产科学杂志, 2004, 1 (1) :85-86. [5]PENG J, HOU JL.Current status and management of pregnancy and anti-HBV therapy[J].Chin J Hepatol, 2011, 19 (3) :236-238. (in Chinese) 彭劼, 侯金林.妊娠与抗乙型肝炎病毒治疗的现状与管理[J].中华肝脏病杂志, 2011, 19 (3) :236-238. [6]LONG ZH, ZHUO SH.Etiology and impact of viral hepatitis in pregnant women[J].Guangzhou Med J, 2007, 38 (3) :45-47. (in Chinese) 龙昭华, 卓树洪.妊娠合并病毒性肝炎的病原学及其对妊娠的影响[J].广州医药, 2007, 38 (3) :45-47. [7]WANG GJ, HAN GR, YU MM, et al.Analysis of maternal and fetal outcome in late pregnancy with severe liver diseases[J].Jiangsu Med J, 2010, 36 (16) :1952-1953. (in Chinese) 王根菊, 韩国荣, 余敏敏, 等.晚期妊娠合并重症肝病的母婴结局分析[J].江苏医药, 2010, 36 (16) :1952-1953. [8]WANG GJ, HAN GR, YU MM.Clinical analysis of 14 pregnant women with severe liver diseases[J].J Southeast Univ:Med Sci Edi, 2008, 27 (6) :443-445. (in Chinese) 王根菊, 韩国荣, 余敏敏.14例妊娠合并重症肝病临床分析[J].东南大学学报:医学版, 2008, 27 (6) :443-445. [9]HAN GR, JIANG HX, WANG GJ, et al.Efficacy and safety of telbivudine in pregnant women to prevent perinatal transmission of hepatitis B virus[J].Chin J Infect Dis, 2012, 20 (3) :201-205. (in Chinese) 韩国荣, 江红秀, 王根菊, 等.替比夫定对乙型肝炎病毒高载量孕妇母婴传播的阻断效果及其安全性[J].中华传染病杂志, 2012, 20 (3) :201-205. [10]ZHU MQ, HUANG XY, JIANG JN, et al.Efficacy and safety of lamivudine for preventing mother-to-child transmission of hepatitis B virus:a systematic review[J].Chin Hepatol, 2012, 17 (2) :99-103. (in Chinese) 祝美琴, 黄晓云, 江建宁, 等.拉米夫定阻断HBV母婴传播疗效及安全性的系统评价[J].肝脏, 2012, 17 (2) :99-103.
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