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目的:探讨乙型肝炎病毒感染伴肝功能异常肝功能指标变化对孕妇早产发生的影响。方法:选择2007年1月-2008年12月间在我院产检及住院分娩的156例孕28周至37周存在肝功异常的乙肝孕妇进行了回顾性分析。结果:晚期妊娠合并病毒性乙型肝炎患者早产组与非早产组血清转氨酶水平比较,差异有统计学意义(P<0.05);两组总胆红素、总胆汁酸水平比较,差异显著(P<0.01)。孕晚期ALT轻度、中度以上异常,早产发生率分别32%、90%,OR分别为2.7、51;AST轻度、中度以上异常,早产发生率分别35%、87%,OR分别为3.1、37.9;总胆汁酸轻度、中度以上异常,早产发生率分别39%、91%,OR分别为3.6、57.2;总胆红素轻度、中度以上异常,早产发生率分别49%、88%,OR分别为5.4、41.6;早产组与非早产组比较,羊水粪染及胎儿宫内窘迫差异有统计学意义(P<0.01),剖宫产率、产后出血、新生儿窒息两组间差异无显著性(P>0.05)。结论:乙肝孕妇晚期妊娠血清ALT和AST、TBA、TBIl水平均与早产发生有关。
Objective: To investigate the impact of hepatitis B virus infection with abnormal liver function indexes on preterm birth in pregnant women. Methods: A retrospective analysis was performed on 156 pregnant women with abnormal liver function during the period from January 2007 to December 2008 in our hospital for medical examination and hospital delivery. Results: The levels of serum aminotransferase in preterm and non-premature children in late pregnancy with viral hepatitis B were significantly different (P <0.05). The total bilirubin and total bile acid levels in the two groups were significantly different (P <0.01). The incidence of mild to moderate ALT in the third trimester of pregnancy was 32% and 90%, respectively, with OR of 2.7 and 51 respectively. The mild and moderate abnormalities of AST were found in 35% and 87% of the preterm birth 3.1,37.9; moderate and severe total bile acid abnormalities, the incidence of preterm birth were 39%, 91% OR were 3.6,57.2; total bilirubin mild to moderate abnormalities, the prevalence of preterm birth were 49% , 88%, respectively, OR 5.4,41.6; preterm birth group and non-premature birth group, meconium amniotic fluid and fetal distress difference was statistically significant (P <0.01), cesarean section rate, postpartum hemorrhage, neonatal asphyxia two No significant difference between groups (P> 0.05). Conclusion: Serum levels of ALT, AST, TBA and TBIl in pregnant women with hepatitis B are associated with preterm birth.