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目的了解总胆汁酸(TBA)检测值在妊娠各型肝炎对胎儿的影响,以提供诊断及处理参考。方法将妊娠期不同病因肝炎与非妊娠期乙型肝炎比较,妊娠肝炎按妊娠孕周时间分组,对比TBA、肝生化检测值和临床转归;比较TBA异常孕妇与其新生儿的阿氏评分,评价TBA对新生儿的影响。结果妊娠肝炎各孕期组与病毒性肝炎组各项肝生化指标及TBA检测值对照差异均无统计学意义(P>0.05)。妊娠期肝炎与非妊娠期乙型肝炎在TBA检测值、ALT、AST及TBil检测值对照均呈正相关(P<0.01)。TBA≥50μmol/L组新生儿与TBA检测值正常组的新生儿阿氏评分对照,差异具有统计学意义(P<0.01)。新生儿评分低的病例多为产科异常。妊娠慢性乙型肝炎(CHB)ALT及TBA均明显高于无明显病因的妊娠期肝炎(P<0.05)。结论妊娠期肝炎肝功异常病例常伴有TBA增高。新生儿阿氏评分低、TBA≥50μmol/L和肝损害程度相关,但多有产科病因可寻,CHB对母婴健康影响较大。
Objective To understand the effect of total bile acid (TBA) in pregnancy on the fetus of various types of hepatitis to provide diagnosis and treatment reference. Methods Hepatitis of different etiology during pregnancy was compared with that of non-pregnant hepatitis B, gestational hepatitis was grouped according to gestational gestational time, and TBA, liver biochemical detection and clinical outcome were compared. The impact of TBA on newborns. Results There was no significant difference in liver biochemical indexes and TBA detection value between pregnancy group and viral hepatitis group in gestational hepatitis (P> 0.05). Gestational hepatitis and non-gestation hepatitis B were positively correlated with TBA, ALT, AST and TBil (P <0.01). Neonates with neonatal TBA≥50μmol / L group and normal TBA group had significant difference (P <0.01). Newborns with low scores are mostly obstetric abnormalities. Pregnancy chronic hepatitis B (CHB) ALT and TBA were significantly higher than those of no obvious cause of pregnancy hepatitis (P <0.05). Conclusion Pregnancy-induced hepatitis with abnormal liver function often accompanied by an increase of TBA. Neonatal Aries score is low, TBA ≥ 50μmol / L and the degree of liver damage related, but many obstetric causes can be found, CHB greater impact on maternal and child health.