干扰素γ诱导蛋白10联合HBV pgRNA对妊娠合并HBV感染孕妇妊娠结局的预测价值

摘要/Abstract

摘要： 目的探究干扰素γ诱导蛋白10(IP-10)联合乙型肝炎病毒(HBV)基因组RNA(pgRNA)对妊娠结局的预测价值。方法选取苏州中西医结合医院2020年3月至2023年12月收治的102例妊娠合并HBV感染孕妇,入院后检测IP-10水平与HBV pgRNA。出院后进行随访(随访截止时间至所有孕妇分娩),根据妊娠结局状况将其分为妊娠结局不良组和良好组,比较两组患者基础资料,分析影响孕妇妊娠不良结局的因素及价值。结果 102例孕妇中有23例出现不良妊娠结局(占比22.55%),其中早产6例,羊水量异常、产后出血24 h出血≥500 mL各5例,胎盘早剥、低体质量儿、巨大儿各2例,生长受限1例。妊娠结局不良组天冬氨酸氨基转移酶(AST)(22.83±3.86)U/L、丙氨酸氨基转移酶(ALT)(17.23±2.54)U/L、HBV pgRNA(5.26±1.14)lg拷贝/mL、IP-10(68.26±6.85)pg/mL均高于妊娠结局良好组(19.74±3.18)U/L、(14.93±2.21)U/L、(4.31±1.04)lg拷贝/mL、(62.14±5.74)pg/mL(均P＜0.05)。Logistic多因素回归分析表明,AST水平(OR=1.349,95% CI:1.132~1.606)、ALT水平(OR=1.583,95% CI:1.232~2.035)、HBV pgRNA水平(OR=2.518,95% CI:1.449~4.375)、IP-10水平(OR=1.185,95% CI:1.078~1.304)是影响妊娠合并HBV感染孕妇妊娠不良结局的主要因素(P<0.05)。HBV pgRNA、IP-10单独预测及联合预测妊娠合并HBV感染孕妇妊娠不良结局灵敏度分别为78.30%、65.20%、91.30%,特异度分别为63.30%、73.40%、86.10%。且HBV pgRNA、IP-10联合预测妊娠合并HBV感染孕妇妊娠不良结局具有较高价值(AUC为0.895)。结论 HBV pgRNA、IP-10与妊娠合并HBV感染孕妇不良妊娠结局相关,联合预测妊娠合并HBV感染孕妇妊娠不良结局的价值较高。

关键词: 干扰素γ诱导蛋白10, HBV基因组RNA, 妊娠, 乙型肝炎病毒感染孕妇, 妊娠结局

Abstract: Objective To investigate the predictive value of interferon Y-inducible protein 10 (IP-10) combined with hepatitis B virus (HBV) genomic RNA (pgRNA) in pregnancy outcomes. Methods A total of 102 pregnant women with HBV infection admitted to Suzhou Hospital of Integrated Traditional Chinese and Western Medicine from March 2020 to December 2023 were selected. IP-10 levels and HBV pgRNA were detected after admission. All pregnant women were followed up from after discharge until all of them gave birth, and they were divided into poor pregnancy outcome group and good pregnancy outcome group according to pregnancy outcomes. The basic data of patients were compared, and the factors affecting the adverse pregnancy outcome were analyzed. Results Among the 102 pregnant women, 23 had adverse pregnancy outcomes (22.55%), including 6 premature births, 5 cases of abnormal amniotic fluid volume, 5 cases of postpartum hemorrhage ≥500 mL, 2 cases of placental abruption, 2 cases of low body weight infant, 2 cases of macrosomia, and 1 case of growth restriction. In the adverse pregnancy outcome group, aspartate aminotransferase (AST) (22.83±3.86) U/L, alanine aminotransferase (ALT) (17.23±2.54) U/L, HBV pgRNA (5.26±1.14) log 10 copies/mL and IP-10 (68.26±6.85) pg/mL were higher than those in the good pregnancy outcome group (19.74±3.18) U/L, (14.93±2.21) U/L and (4.31±1.04) log 10 copies/mL, (62.14±5.74) pg/mL (all P<0.05). Logistic analysis showed that the levels of AST [OR=1.349 (95%CI: 1.132~1.606)], ALT [OR=1.583 (95%CI: 1.232~2.035)], HBV pgRNA [OR=2.518 (95%CI: 1.449~4.375)] and IP-10 [OR=1.185 (95%CI: 1.078~1.304)] were the main factors affecting adverse pregnancy outcomes in pregnant women with HBV infection (P<0.05). The sensitivity and specificity of HBV pgRNA and IP-10 in predicting adverse pregnancy outcomes were 78.30%, 65.20% and 91.30%, respectively, and 63.30%, 73.40% and 86.10%, respectively. Moreover, the combinatiob of HBV pgRNA and IP-10 had a high value in predicting adverse pregnancy outcomes in pregnant women with HBV infection (AUC of 0.895). Conclusion HBV pgRNA and IP-10 are associated with adverse pregnancy outcomes in pregnant women with HBV infection, and the combined prediction of adverse pregnancy outcomes has the high value.

Key words: Interferon γ inducible protein 10, HBV genomic RNA, Pregnancy, Pregnant women infected with hepatitis B virus, Pregnancy outcome

余虹云, 黄燕, 丁建芬, 蔡良良, 束长珍. 干扰素γ诱导蛋白10联合HBV pgRNA对妊娠合并HBV感染孕妇妊娠结局的预测价值[J]. 肝脏, 2025, 30(10): 1379-1383.

YU Hong-yun, HUANG Yan, DING Jian-fen, CAI Liang-liang, SHU Chang-zhen. Predictive value of interferon γ inducible protein 10 combined with HBV pgRNA for pregnancy outcomes in pregnant women with HBV infection[J]. Chinese Hepatolgy, 2025, 30(10): 1379-1383.

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