Zeng Z, Zhou M F, Lin Y J, Bi X Y, Yang L, Deng W, Jiang T T, Hu L P, Xu M J, Zhang L, Yi W, Li M H
Department of Hepatology Division 2, Peking University Ditan Teaching Hospital, Beijing 100015, China.
Departmentof Obstetrics and Gynecology, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China.
Zhonghua Gan Zang Bing Za Zhi. 2024 Feb 20;32(2):113-118. doi: 10.3760/cma.j.cn501113-20231122-00216.
To analyze the clinical features of postpartum hepatitis flares in pregnant women with hepatitis B virus (HBV) infection. A retrospective study was conducted. Patients who met the enrollment criteria were included. Liver function and HBV virology tests were collected from pregnant women with chronic HBV infection at delivery, 6, 24, 36, and 48 weeks after delivery through the hospital information and test system. Additionally, antiviral therapy types and drug withdrawal times were collected. Statistical analysis was performed on all the resulting data. A total of 533 pregnant women who met the inclusion criteria were included, with all patients aged (29.5±3.7) years old. A total of 408 cases received antiviral drugs during pregnancy to interrupt mother-to-child transmission. There was no significant difference in the levels of alanine aminotransferase (ALT, = -1.981, = 0.048), aspartate aminotransferase (AST, = -3.956, < 0.001), HBV load ( = -15.292, < 0.001), and HBeAg ( = -4.77, < 0.001) at delivery in patients who received medication and those who did not. All patients ALT, AST, total bilirubin, direct bilirubin, and albumin showed an upward trend within six weeks after delivery. A total of 231 cases developed hepatitis within 48 weeks after delivery. Among them, 173 cases first showed ALT abnormalities within six weeks postpartum. Hepatitis flare incidence peaked six weeks after delivery or six weeks after drug withdrawal in pregnant women with chronic HBV infection.
分析乙型肝炎病毒(HBV)感染孕妇产后肝炎发作的临床特征。进行了一项回顾性研究。纳入符合入选标准的患者。通过医院信息和检测系统收集慢性HBV感染孕妇分娩时、产后6周、24周、36周和48周的肝功能及HBV病毒学检测结果。此外,收集抗病毒治疗类型和停药时间。对所有所得数据进行统计分析。共纳入533例符合纳入标准的孕妇,所有患者年龄为(29.5±3.7)岁。共有408例患者在孕期接受抗病毒药物以阻断母婴传播。接受药物治疗和未接受药物治疗的患者在分娩时丙氨酸氨基转移酶(ALT, = -1.981, = 0.048)、天冬氨酸氨基转移酶(AST, = -3.956, < 0.001)、HBV载量( = -15.292, < 0.001)和HBeAg( = -4.77, < 0.001)水平无显著差异。所有患者的ALT、AST、总胆红素、直接胆红素和白蛋白在产后六周内均呈上升趋势。共有231例患者在产后48周内发生肝炎。其中,173例在产后六周内首次出现ALT异常。慢性HBV感染孕妇肝炎发作发生率在产后六周或停药后六周达到峰值。