论文部分内容阅读
目的探讨HBV-DNA阳性慢性乙型肝炎(CHB)孕妇自然病程下不同孕期乙型肝炎病毒(hepatitis B Virus,HBV)载量的动态变化及与肝功能指标的相关性。方法收集27例HBV-DNA阳性的CHB孕妇作为研究对象,分别在孕早期(T1期)、孕中期(T2期)、孕晚期(T3期)采血,用荧光定量PCR(FQ-PCR)法检测血清HBV-DNA含量;用全自动生化仪检测肝功能相关指标;电化学发光法检测“乙肝两对半”血清标志物指标。采用SPSS13.0统计软件进行统计分析。结果在自然病程下的CHB孕妇,其HBV-DNA的复制水平增加,在T1期、T2期、T3期呈升高趋势,且差异有统计学意义(P均<0.05)。对不同孕期CHB孕妇血清中的肝功能检测指标进行比较,仅发现AST、GGT较对照组异常升高,且随孕期的增加不断升高,伴随妊娠全过程(P均<0.05)。对各个孕期HBV-DNA载量与肝功能指标进行相关性分析,发现HBV病毒载量的高低与肝功能无显著相关性(P均>0.05)。结论 (1)自然病程下的CHB孕妇HBV-DNA载量呈升高趋势。对于不接受治疗的CHB孕妇,应加强随访,控制母婴传播的风险。(2)HBV-DNA阳性CHB孕妇在未经抗病毒治疗的情况下,可能存在一定程度肝细胞的损害。(3)HBV-DNA载量与肝功能指标并无显著相关性,不能以病毒载量的高低判断肝功能受损程度。
Objective To investigate the dynamic changes of hepatitis B virus (HBV) load in pregnant women with HBV-DNA-positive chronic hepatitis B (CHB) during the natural course and their correlation with liver function. Methods Twenty-seven CHB pregnant women with HBV-DNA positive were collected and collected for blood samples in the first trimester of pregnancy (T1), second trimester (T2) and third trimester of pregnancy (T3), and then detected by FQ-PCR Serum HBV-DNA content; using automatic biochemical analyzer to detect liver function-related indicators; Electrochemiluminescence detection “Hepatitis B two and a half” serum markers. Using SPSS13.0 statistical software for statistical analysis. Results The CHB pregnant women under natural history had an increased level of HBV-DNA replication, showing an increasing trend in T1, T2 and T3, with statistical significance (all P <0.05). The serum levels of CHB in different pregnant women were compared. Only AST and GGT were found to be abnormally elevated compared with the control group, and increased with the increase of pregnancy, accompanied with the whole process of pregnancy (all P <0.05). Correlation analysis of HBV-DNA load and liver function index in each pregnancy showed no significant correlation between HBV viral load and liver function (all P> 0.05). Conclusions (1) The HBV-DNA load of CHB pregnant women in the natural course is increasing. For non-treated CHB pregnant women, follow-up should be strengthened to control the risk of mother-to-child transmission. (2) HBV-DNA-positive CHB pregnant women may have some degree of hepatocyte damage without antiviral treatment. (3) There was no significant correlation between HBV-DNA load and liver function index, and the degree of liver damage could not be judged by the level of viral load.