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目的:探讨妊娠期肝病对围产儿的影响。方法:测定47例正常孕妇和637例妊娠期肝病孕妇所生648名新生儿的Apgar分值和出生时体重。结果:与病毒性肝炎孕妇相比,对照组和乙肝病毒携带产妇所生新生儿Apgar分值和出生时体重均有显著差异(均P<0.01),而ICP孕妇所生新生儿Apgar分值和出生时体重则均无显著差异(均P>0.05)。肝功能异常孕妇血清总胆红素,直接胆红素和总胆汁酸与新生儿Apgar分值和出生时体重呈非常显著和显著负相关(均P<0.01,均P<0.05),而血清谷丙转氨酶、谷草转氨酶和碱性磷酸酶与新生儿Apgar评分和出生时体重却无显著相关关系(均P>0.05)。血清白蛋白和总蛋白水平与1分钟Apgar评分分别有非常显著和显著正相关(P<0.01,P<0.05)。结论:孕妇病毒性肝炎与ICP对围产儿生长发育和出生时状态影响相似。肝功能异常孕妇血清胆红素和胆汁酸水平可能与围产儿生长发育和出生时状态有关,而血清白蛋白水平可能与新生儿出生时状态有关。
Objective: To investigate the effect of gestational liver disease on perinatal children. Methods: Apgar score and birth weight of 648 newborns born in 47 normal pregnant women and 637 pregnant women with liver disease were measured. Results: Compared with pregnant women with viral hepatitis, Apgar score and birth weight of neonates born in the control group and HBV carriers were significantly different (all P <0.01), while Apgar scores of neonates born to ICP pregnant women and There was no significant difference in birth weight (P> 0.05). Serum total bilirubin, direct bilirubin and total bile acid in pregnant women with abnormal liver function were significantly and significantly negatively correlated with Apgar score and birth weight (P <0.01, all P <0.05), whereas Serum Valley Aminotransferase, aspartate aminotransferase and alkaline phosphatase and Neonatal Apgar score and birth weight but no significant correlation (P> 0.05). There was a significant and significant positive correlation between serum albumin and total protein levels and Apgar score at 1 minute (P <0.01, P <0.05). Conclusion: The effects of viral hepatitis in pregnant women and ICP on perinatal growth and birth status are similar. Serum bilirubin and bile acid levels in pregnant women with abnormal liver function may be related to the status of perinatal growth and development, and serum albumin levels may be related to the newborn’s status at birth.