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目的探讨乙肝病毒感染的母亲妊娠期合并低蛋白血症对母亲及新生儿的影响。方法对2012年4月1日至7月31日于我院分娩的192例乙肝病毒感染的母亲及其新生儿的临床资料进行分析总结。按母亲分娩前1周内血清总蛋白及白蛋白含量分为2组:低蛋白血症组(A组)92例,和血浆蛋白正常组(B组)100例,对两组母亲的孕产期情况,包括是否发生妊娠期糖尿病(包括糖耐量异常)、胎儿宫内窘迫、早产、羊水异常及新生儿出生后Apgar评分、体重以及出生后1小时静脉血浆蛋白含量进行比较。结果 A组母亲并发妊娠期糖尿病6例(6.5%)、胎儿宫内窘迫12例(13.0%),B组分别为1例(1.0%)和5例(5.0%),A组的发生率均高于B组(P<0.05),早产、羊水异常发生率两组差异无统计学意义(P>0.1);A组新生儿1分钟阿氏评分7.4±1.1分,血浆总蛋白65.63±7.77g/L,白蛋白41.83±3.15g/L,B组新生儿分别为8.3±1.2分,67.76±6.47g/L,43.39±3.28 g/L,A组均不同程度低于B组,差异有统计学意义(分别P<0.05,P<0.001)。新生儿出生体重及5分钟、10分钟阿氏评分无显著性差异。结论乙肝病毒感染的母亲,并发低蛋白血症者较血浆蛋白正常者可能更易合并妊娠期糖尿病、胎儿宫内窘迫,同时与其新生儿的1分钟阿氏评分,血浆蛋白和/或白蛋白更低存在相关性,故积极纠正妊娠期低蛋白血症对HBV感染母亲及其新生儿都有重要意义。
Objective To investigate the effect of hepatitis B virus infection in mothers and neonates during pregnancy with hypoproteinemia. Methods The clinical data of 192 mothers with hepatitis B virus infection and their newborns who were delivered in our hospital from April 1 to July 31, 2012 were analyzed and summarized. According to the level of serum total protein and albumin in the first week before delivery, the two groups were divided into two groups: 92 in hypoproteinemia group (A group) and 100 in normal plasma protein group (B group) Period, including the occurrence of gestational diabetes (including impaired glucose tolerance), fetal distress, preterm birth, amniotic fluid abnormalities and neonatal Apgar score, body weight and venous plasma protein content after 1 hour of birth were compared. Results A group of 6 pregnant women with gestational diabetes mellitus (6.5%), 12 cases of fetal distress (13.0%), 1 case (1.0%) and 5 cases (5.0% (P <0.05). There was no significant difference in the incidence of preterm birth and amniotic fluid abnormalities between the two groups (P> 0.05). The newborns in group A had a score of 7.4 ± 1.1 at 1 minute, plasma total protein 65.63 ± 7.77g / L albumin 41.83 ± 3.15g / L, respectively, the newborns in group B were 8.3 ± 1.2, 67.76 ± 6.47g / L and 43.39 ± 3.28g / L, respectively. The difference in group A was less than that in group B Significance (P <0.05, P <0.001, respectively). Neonatal birth weight and 5 minutes, 10 minutes Ah was no significant difference. Conclusions Hepatitis B virus-infected mothers with concomitant hypoproteinemia may be more likely to have gestational diabetes mellitus and fetal distress than those with normal plasma protein, while having a 1-minute Ashkenai score, lower plasma protein and / or albumin level in their neonate There is a correlation, so actively correcting hypoproteinemia during pregnancy are important for HBV infection in mothers and their newborns.