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目的 探讨妊娠期肝炎病毒多重感染对母婴的影响。方法 对 1994年 1月至 1999年12月在我院产前检查 ,肝功能异常的孕妇行甲、乙、丙、丁、戊等 5种肝炎病毒标记物检测 ,其中确诊为肝炎病毒多重感染者 3 2例 (多重感染组 ) ,确诊为肝炎病毒单一感染者 3 2例 (单一感染组 ) ,对两组母儿并发症及预后进行观察比较。结果 两组丙氨酸转氨酶 (ALT)、天冬氨酸转氨酶 (AST)、血清总胆红素 (TBIL)水平比较 ,差异无显著性 (P >0 0 5 )。多重感染组乙型肝炎病毒e抗原 (HBeAg)阳性率( 3 5 7% )显著低于单一感染组 ( 76 9% ,P <0 0 5 ) ,而乙型肝炎病毒e抗体 (HBeAb)阳性率 ( 5 7 1% )显著高于单一感染组 ( 15 4 % ,P <0 0 1)。多重感染组孕妇妊娠高血压综合征 (妊高征 )、产后出血、重症肝炎、死亡的发生率与单一感染组比较 ,差异无显著性 (P >0 0 5 )。而多重感染组胎膜早破、早产的发生率 ( 2 8 1% ,2 5 0 % )明显高于单一感染组 ( 6 3 %、3 1% ,P <0 0 5 ) ;胎儿宫内窘迫及新生儿窒息的发生率 ( 3 1 3 % ,2 5 0 % )显著高于单一感染组 ( 9 4 %、0 0 % ,P <0 0 5、P <0 0 1)。结论 妊娠期肝炎病毒多重感染对孕妇的影响无明显加重 ,而对围产儿的影响较为明显 ;应加强孕期保健 ,防止胎膜早破及早产?
Objective To investigate the influence of multiple infections of hepatitis during pregnancy on maternal and infant. Methods From January 1994 to December 1999 in our hospital prenatal examination, abnormal liver function in pregnant women were A, B, C, D, E five kinds of hepatitis virus markers detection, which was diagnosed as hepatitis virus multiple infection In 32 cases (multiple infection group), 32 patients (single infection group) with single infection of hepatitis virus were diagnosed. Complications and prognosis of the two groups were observed and compared. Results There was no significant difference in the levels of ALT, AST and TBIL between the two groups (P> 0.05). The positive rate of hepatitis B virus e antigen (HBeAg) in multiple infection group was significantly lower than that in single infection group (76.9%, P <0.05), while the positive rate of HBeAb (57.1%) was significantly higher than that of single infection group (15.4%, P <0.01). The incidence of pregnancy-induced hypertension (PIH), postpartum hemorrhage, severe hepatitis and death in pregnant women with multiple infection group was not significantly different from those in single infection group (P> 0.05). However, the incidence of premature rupture of membranes, premature delivery in multiple infection group was significantly higher than that in single infection group (68%, 31%, P <0.05), fetal distress And the incidence of neonatal asphyxia (33.3%, 25.0%) were significantly higher than those in the single infection group (9.4%, 0%, P <0.05, P <0.01). Conclusion The multiple infection of hepatitis B virus during pregnancy has no obvious effect on pregnant women, but the effect on perinatal children is more obvious. It should be strengthened during pregnancy to prevent premature rupture of membranes and premature labor.