妊娠期糖尿病患者慢性乙型肝炎病毒感染的临床危险因素研究

摘要

目的 分析妊娠期糖尿病患者慢性乙型肝炎病毒感染的临床危险因素,以改善该类患者妊娠结局.方法 随机选取2016年2月至2018年2月在本院接受孕检并住院分娩的493例孕妇为观察对象,将其中229例未合并乙型肝炎病毒感染的孕妇作为试验A组、合并慢性乙型肝炎病毒感染的38例孕妇作为试验B组,同时将226例健康孕妇作为对照组,采用回顾性调查方式详细记录、统计、分析本研究493例孕妇的临床资料,认真记录并比较3组孕妇的妊娠结局,分析妊娠期糖尿病慢性乙型肝炎病毒感染的临床危险因素.结果 试验A组、试验B组与对照组剖宫产、产后出血、早产、新生儿窒息等妊娠结局的发生率差异无统计学意义(均P＞ 0.05);试验B组妊娠期肝内胆汁淤积症、急性绒毛膜羊膜炎、胎儿窘迫、巨大儿发生率明显高于试验A组及对照组.493例孕妇中有38例妊娠期糖尿病患者发生慢性乙型肝炎病毒感染,感染发生率为7.70％.吸烟史、饮酒史、HBsAg、ALT、GGT等对慢性乙型肝炎病毒感染发生率影响明显,差异有统计学意义(均P＜ 0.05).结论 吸烟史、饮酒史、HBsAg、ALT、GGT等是妊娠期糖尿病患者慢性乙型肝炎病毒感染的临床危险因素,故患者应该培养良好的生活习惯,通过合理适宜的饮食、适当适量的运动及采取安全有效的措施控制血糖及抗病毒治疗以改善妊娠结局.%Objective To analyze the clinical risk factors of chronic hepatitis B virus infection in patients with gestational diabetes,and to improve the pregnancy outcomes of such patients.Methods A total of 493 pregnant women who received pregnancy tests and were hospitalized from February,2016 to February,2018 were selected as observation objects.Among them,229 pregnant women without hepatitis B virus infection were included in the test group A,38 pregnant women with chronic hepatitis B virus infection were set as test group B,and 226 healthy pregnant women were set as a control group.The clinical data of the 493 pregnant women were recorded and statistically analyzed in a retrospective survey.The three groups' pregnancy outcomes were carefully recorded and compared.The clinical risk factors for chronic hepatitis B virus infection in gestational diabetes patients were analyzed.Results There were no statistical differences in the incidences of cesarean section,postpartum hemorrhage,premature delivery,neonatal asphyxia,etc.among the three groups (all P ＞ 0.05).The incidences of intrahepatic cholestasis,acute chorioamnionitis,fetal distress,and macrosomia was significantly higher in the test group B than in the test group A and the control group.Among the 493 pregnant women,38 patients with gestational diabetes mellitus had chronic hepatitis B virus infection,and the infection rate was 7.70％.Smoking history,drinking history,HBsAg,ALT,GGT,etc.had significant effects on the incidence of chronic hepatitis B virus infection,and the differences were statistically significant (all P ＜ 0.05).Conclusions Smoking history,drinking history,HBsAg,ALT,GGT,etc.are clinical risk factors for chronic hepatitis B virus infection in patients with gestational diabetes.Therefore,the patients should cultivate good living habits and take reasonable and appropriate diet,appropriate moderate exercise,safe and effective control of blood glucose,and antiviral therapy,so as to improve pregnancy outcomes.