关键词: 慢性乙型肝炎, 妊娠期肝内胆汁淤积症, 危险因素

Abstract: Objective To analyze the risk factors of intrahepatic cholestasis of pregnancy （ICP） in patients with hepatitis B. Methods 258 pregnant women with hepatitis B between January 2014 and April 2016 were included in this study,and 36 cases out of them were complicated with ICP. 36 patients with ICP and 222 patients without ICP were analyzed by univariate analysis,and then multivariate Logistic regression analysis was applied to get the independent risk factors of ICP. Results The percentage of ICP was 14.0% in this series;the family history of ICP,hypertension,urine protein positive and high estrogen levels in ICP group were 13.9%,22.2%,36.1% and 58.3%,much higher than in non-ICP group（1.8%,8.6%,5.9% and 7.7%,respectively,all P<0.05）;serum alanine aminotransferase（ALT）,alkaline phosphatase（ALP）,blood urea nitrogen（BUN）,total bilirubin（TBIL） and total bile acid （TBA） levels in ICP group were （119.2±10.2 U/L, 139.1±15.4 U/L, 5.5±0.5 mmol/L, 48.9±6.5 μmol/L and 15.5±2.0μmol/L,much higher than in non-ICP group （78.3±8.3 U/L,98.5±14.2 U/L, 4.6±0.4 mmol/L,32.0±5.1 μmol/L and 9.1±1.5 μmol/L,all P<0.05）;blood fibrinogen level in ICP group was（2.1±0.6）g/L, much lower than in non-ICP group [（2.9±0.5）g/L,P<0.05];age,proportion of first pregnancy,body mass index（BMI） and proportion of diabetes in ICP group were 28.6±4.1 year-old,61.1%,25.9±1.2 kg/m² and 13.9%,and in non-ICP group were 27.8±4.2 year-old,59.0%,25.5±1.1 kg/m² and 11.3%,all without statistically significant differences（P>0.05）;multivariate analysis showed that ICP family history,hypertension,urine protein positive and high estrogen levels were the independent risk factors of ICP in pregnant women with hepatitis B. Conclusion The ICP family history,hypertension,urine protein positive and high estrogen levels will increase the risk of ICP occurrence in pregnant women with hepatitis B.

Key words: Hepatitis B, Intrahepatic cholestasis of pregnancy, Risk factors