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目的探究未治疗的慢性乙肝阳性孕妇在妊娠不同时期血清HBV-DNA定量变化及与肝功能指标的联系。方法选取在我院进行全程产检并确诊为慢性乙肝阳性的35例孕妇为观察组,并选取同时期进行孕期检查未查出有乙型肝炎的36例孕妇作为对照组。比两组孕妇在不同孕期时血清肝功能指标水平差异;比较不同孕期观察组研究对象HBV-DNA及乙肝标志物定量变化;分析不同孕期观察组孕妇HBV-DNA定量与相关肝功能指标的联系。结果观察组孕妇在不同孕期血清肝功能检测指标中ALT、GGT水平较对照组明显增加,且随孕期的发展而不断上升;观察组孕妇随着孕期的发展,HBV-DNA定量值也在逐渐增加,乙肝标志物HBs Ag、HBe Ag定量变化不大无意义;根据Pearson检验分析不同孕期观察组血清HBV-DNA定量与肝功能指标ALT、GGT的相关性得出,观察组各孕期血清HBV-DNA定量与ALT、GGT无明显相关性。结论不接受治疗的乙肝HBVDNA阳性孕妇随着孕期的发展,HBV-DNA定量虽呈逐渐上升趋势,但不能作为评价肝功能损伤程度的指标,需增加此类孕妇肝功能及随访观察,注意其病情变化和风险评估。
Objective To investigate the quantitative changes of serum HBV-DNA in untreated chronic hepatitis B-positive pregnant women at different stages of pregnancy and its correlation with liver function indexes. Methods Totally 35 pregnant women diagnosed as CHB positive in our hospital were selected as the observation group and 36 pregnant women who did not detect hepatitis B in the same period were selected as the control group. The difference of serum liver function indexes between the two groups of pregnant women at different stages of pregnancy was compared. The quantitative changes of HBV-DNA and HBV markers were compared among different pregnant groups. The relationship between HBV-DNA levels and related liver function indexes of pregnant women in different pregnancy groups was analyzed. Results The serum levels of ALT and GGT in the serum of pregnant women in the observation group were significantly higher than those in the control group at different stages of pregnancy, and they increased with the development of pregnancy. The pregnant women in the observation group also increased their HBV-DNA quantitative values as their pregnancy progressed , HBs Ag and HBe Ag were not changed meaningly. According to the Pearson test, the relationship between serum HBV-DNA and ALT and GGT in different pregnancy groups was analyzed. The serum HBV-DNA Quantitative and ALT, GGT no significant correlation. Conclusion HBV-DNA in pregnant women who did not receive HBV-DNA positive pregnancy increased gradually with the development of pregnancy. However, they could not be used as an index to evaluate the degree of liver function impairment. The liver function of these pregnant women should be increased and their follow-up observation should be followed Change and risk assessment.