谢明珠 林晓瑜 林伟玲

【摘要】 目的：探討妊娠期高血压疾病合并乙型肝炎病毒（HBV）感染孕妇肝功能指标及妊娠结局情况。方法：选取2016年1-12月本院产科住院进行分娩的200例孕妇。根据孕妇情况分为正常妊娠组（n=53）、妊娠期高血压疾病组（n=55）、妊娠合并HBV感染组（n=48）及妊娠期高血压疾病合并HBV感染组（n=44）。比较四组妊娠晚期肝功能指标水平（ALT、AST、TBIL、TBA）以及不良妊娠结局情况。结果：正常妊娠组ALT、AST、TBIL、TBA水平均低于妊娠期高血压疾病组，妊娠期高血压疾病组ALT、AST、TBIL、TBA水平均低于妊娠合并HBV感染组，妊娠合并HBV感染组ALT、AST、TBIL、TBA水平均低于妊娠期高血压疾病合并HBV感染组，各组间比较差异均有统计学意义（P<0.05）；妊娠期高血压疾病合并HBV感染组早产、胎盘早剥、产后出血、产褥感染发生率均高于正常妊娠组，且早产发生率均高于妊娠期高血压疾病组、妊娠合并HBV感染组，胎盘早剥发生率高于妊娠合并HBV感染组，比较差异均有统计学意义（P<0.05）。结论：妊娠期高血压疾病合并HBV感染患者可加重肝功能损伤，增加妊娠不良结局发生率，对患者肝功能和正常妊娠造成严重影响。

【关键词】 妊娠期高血压疾病； 妊娠合并HBV感染； 肝功能； 妊娠结局

【Abstract】 Objective：To investigate the liver function index and pregnancy outcome of pregnant women with hypertensive disorder complicating hepatitis B virus（HBV） infection.Method：A total of 200 pregnant women who hospitalized in obstetrics department of our hospital from January to December 2016 were selected.According to the situation of pregnant women，they were divided into normal pregnancy group（n=53），hypertensive disorder complicating pregnancy group（n=55），pregnancy combined with HBV infection group（n=48），hypertensive disorder complicating pregnancy combined with HBV infection group（n=44）.The levels of liver function indexes（ALT，AST，TBIL，TBA） and adverse pregnancy outcomes in four groups were compared.Result：The levels of ALT，AST，TBIL and TBA in normal pregnancy group were lower than those of hypertensive disorder complicating pregnancy group，the levels of ALT，AST，TBIL and TBA in hypertensive disorder complicating pregnancy group were lower than those of pregnancy complicated with HBV infection group，the levels of ALT，AST，TBIL and TBA in pregnant women with HBV infection group were lower than those of hypertensive disorder complicating pregnancy combined with HBV infection group，the differences between each group were statistically significant（P<0.05）.The incidence of premature delivery，placental abruption，postpartum hemorrhage and puerperal infection in hypertensive disorder complicating pregnancy combined with HBV infection group were higher than those of normal pregnancy group，the incidence of preterm delivery was higher than that of hypertensive disorder complicating pregnancy group and pregnancy combined with HBV infection group，the incidence of placental abruption was higher than that of pregnancy combined with HBV infection group，the differences were statistically significant（P<0.05）.Conclusion：Hypertensive disorder complicating pregnancy complicated with HBV infection can aggravate liver function damage，increase the incidence of bad pregnancy outcome，and have a serious effect on the liver function and normal pregnancy.

【Key words】 Hypertensive disorder complicating pregnancy； Pregnancy combined with HBV infection；Liver function； Pregnancy outcome

First-authors address：Shantou Chenghai District Peoples Hospital，Shantou 515800，China

doi：10.3969/j.issn.1674-4985.2018.24.010

我国为乙型肝炎病毒（HBV）感染大国，母婴传播是主要传播途径之一，不仅增加乙型肝炎发病率，还影响母婴妊娠安全。临床统计指出，我国孕妇合并HBsAg阳性率约为22.1%，妊娠期孕妇代谢旺盛，乙肝可加重患者肝功能负担，影响患者肝功能代谢[1]。妊娠期高血压疾病为妊娠期特有疾病，以血压升高、蛋白尿为主要临床特征，一定程度上同样可影响肝功能正常代谢[2]。临床中对妊娠期高血压疾病合并乙肝孕妇肝功能变化及妊娠结局研究甚少，此次研究针对妊娠期高血压疾病合并乙肝孕妇进行随访和研究，探究妊娠期高血压疾病对乙肝孕妇患者肝功能及妊娠结局影响情况，现报道如下。

1 资料与方法

1.1 一般资料 选取2016年1-12月本院产科住院进行分娩的200例孕妇为研究对象。……