妊娠期急性脂肪肝患者的主要临床检验指标分析

doi:10.3877/cma.j.issn.2095-3232.2013.06.009

中华肝脏外科手术学电子杂志 ›› 2013, Vol. 02 ›› Issue (06) : 383 -385. doi: 10.3877/cma.j.issn.2095-3232.2013.06.009

所属专题：文献；

临床研究

妊娠期急性脂肪肝患者的主要临床检验指标分析

魏绪霞¹, 易小猛¹, 吕海金¹, 熊亮¹, 刘剑戎¹, 李敏如¹, 安玉玲¹, 危敏¹, 易慧敏¹^,^†(

)

^1. 510630　广州，中山大学附属第三医院外科重症监护病房

收稿日期:2013-08-19 出版日期:2013-12-10
通信作者: 易慧敏
基金资助:
广州市科技计划项目(2011Y1-0033-1)

Analysis on the major clinical indicators in patients with acute fatty liver of pregnancy

Xu-xia WEI¹, Xiao-meng YI¹, Hai-jin LYU¹, Liang XIONG¹, Jian-rong LIU¹, Min-ru LI¹, Yu-ling AN¹, Min WEI¹, Hui-min YI¹^,^†()

^1. Surgi-cal Intensive Care Unit, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China

Received:2013-08-19 Published:2013-12-10
Corresponding author: Hui-min YI
About author:
Corresponding author: YI Hui-min, Email: ylhmin@hotmail.com

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目的

探讨妊娠期急性脂肪肝患者的主要临床检验指标变化特点。

方法

回顾性研究2009年3月至2013年8月在中山大学附属第三医院接受诊治的26例妊娠期急性脂肪肝患者临床资料。根据患者临床结局分为好转组与未好转组。好转组20例，年龄18~30岁，中位年龄25岁；未好转组6例，年龄20~29岁，中位年龄24岁。所有患者均签署知情同意书，符合医学伦理学规定。观察两组患者转入重症监护病房（ICU）24 h外周静脉血总胆红素（TB）、凝血酶原活动度（PTA）、血清肌酐（Scr）、空腹血糖（FPG）和动脉血乳酸（Lac）等主要临床检验指标的差异。两组患者主要临床检验指标的比较采用t检验。

结果

好转组转入ICU 24 h TB、PTA、Scr、FPG、Lac分别为（193±99）μmol/L、（48±17）%、（114±84）μmol/L、（5.7±2.9）mmol/L、（2.8±1.0）mmol/L，未好转组分别为（259±119）μmol/L、（37±14）%、（161±79）μmol/L、（4.7±2.6）mmol/L、（3.9±1.5）mmol/L，两组患者相应指标比较差异有统计学意义（t=-8.178，8.231，-11.913，7.541，-10.032；P<0.05）。

结论

妊娠期急性脂肪肝患者TB、PTA、Scr、FPG、Lac等主要临床检验指标异常，预后差者其异常更为明显。

关键词: 妊娠, 脂肪肝, 胆红素, 凝血酶原, 肌酸酐, 血糖, 乳酸

Objective

To investigate the characteristics of major clinical indicators changes in patients with acute fatty liver of pregnancy.

Methods

Clinical data of 26 patients with acute fatty liver of pregnancy from March 2009 to August 2013 in the Third Affiliated Hospital of Sun Yat-sen University were analyzed retrospectively. According to the clinical outcome, patients were divided into improvement group (n=20, 18-30 years old, median age of 25 years old) and no-improvement group (n=6, 20-29 years old, median age of 24 years old). The informed consents of all patients were obtained and the ethical committee approval was received. The differences of major clinical indicators such as total bilirubin (TB), prothrombin time activity (PTA), serum creatinine (Scr), fasting blood glucose (FPG) of peripheral venous blood and arterial lactic acid (Lac) in patients of two groups were observed at 24 h after transferred into the intensive care unit (ICU). The major clinical indicators in patients of two groups were compared by t test.

Results

The TB, PTA, Scr, FPG, Lac were (193±99)μmol/L, (48±17)%, (114±84)μmol/L, (5.7±2.9)mmol/L, (2.8±1.0)mmol/L respectively in improvement group 24 h after transferred into ICU, and were (259±119) μmol/L,(37±14)%, (161±79)μmol/L, (4.7±2.6)mmol/L, (3.9±1.5)mmol/L respectively in no-improvement group, where significant differences were observed in the corresponding indexes between two groups(t=-8.178, 8.231,-11.913, 7.541,-10.032; P<0.05).

Conclusions

The major clinical indicators such as TB, PTA, Scr, FPG, Lac in patients with acute fatty liver of pregnancy are abnormal. It is even obvious in patients with poor prognosis.

Key words: Pregnancy, Fatty liver, Bilirubin, Prothrombin, Creatinine, Blood glucose, Lactic acid

表1 两组患者转入重症监护病房24 h临床检验指标比较（±s）

组别	例数	WBC(×10⁹/L)	PLT(×10⁹/L)	ALB(g/L)	ALT(U/L)	TB(μmol/L)	PTA(%)	Scr (μmol/L)	FPG(mmol/L)	Lac(mmol/L)
好转组	20	13±3	167±67	27±6	131±72	193±99	48±17	114±84	5.7±2.9	2.8±1.0
未好转组	6	15±4	159±51	26±5	129±65	259±119	37±14	161±79	4.7±2.6	3.9±1.5
t值	?	-0.511	1.378	1.002	0.490	-8.178	8.231	-11.913	7.541	-10.032
P值	?	>0.05	>0.05	>0.05	>0.05	<0.05	<0.05	<0.05	<0.05	<0.05

表1 两组患者转入重症监护病房24 h临床检验指标比较（±s）

组别	例数	WBC(×10⁹/L)	PLT(×10⁹/L)	ALB(g/L)	ALT(U/L)	TB(μmol/L)	PTA(%)	Scr (μmol/L)	FPG(mmol/L)	Lac(mmol/L)
好转组	20	13±3	167±67	27±6	131±72	193±99	48±17	114±84	5.7±2.9	2.8±1.0
未好转组	6	15±4	159±51	26±5	129±65	259±119	37±14	161±79	4.7±2.6	3.9±1.5
t值	?	-0.511	1.378	1.002	0.490	-8.178	8.231	-11.913	7.541	-10.032
P值	?	>0.05	>0.05	>0.05	>0.05	<0.05	<0.05	<0.05	<0.05	<0.05

[1]	蒋佩茹,邱申熊.妊娠期肝病2137例临床分析.肝脏, 2006, 11(4): 247-248.
[2]	刘双莲,刘丽华.急性妊娠脂肪肝的临床分析.华西医学, 2010, 25(2): 384-385.
[3]	Ch′ng CL,Morgan M,Hainsworth I, et al. Prospective study of liver dysfunction in pregnancy in Southwest Wales. Gut, 2002, 51(6): 876-880.
[4]	Brooks RR,Feller CM,Maye JP. Acute fatty liver of pregnancy: a case report. AANA J, 2002, 70(3): 215-217.
[5]	Guntupalli SR,Steingrub J. Hepatic disease and pregnancy: an overview of diagnosis and management. Crit Care Med, 2005, 33(10 Suppl): S332-S339.
[6]	Lamireau D,Feghali H,Redonnet-Vernhet I, et al. Acute fatty liver in pregnancy: revealing fetal fatty acid oxidation disorders.Arch Pediatr（法文）, 2012, 19(3): 277-281.
[7]	Tein I. Metabolic disease in the fetus predisposes to maternal hepatic complications of pregnancy. Pediatr Res, 2000, 47(1): 6-8.
[8]	Bellig LL. Maternal acute fatty liver of pregnancy and the associated risk for long-chain 3-hydroxyacyl-coenzyme a dehydrogenase(LCHAD) deficiency in infants. Adv Neonatal Care, 2004, 4(1): 26-32.
[9]	曹泽毅.中华妇产科学. 2版.北京:人民卫生出版社, 2005：652-655.
[10]	张丽志,刘清华.妊娠期急性脂肪肝9例临床分析.实用妇产科杂志, 2006, 22(9): 546-548.
[11]	徐道振.病毒性肝炎临床实践.北京:人民卫生出版社, 2006: 239-314.
[12]	Yuen MF,Sablon E,Hui CK, et al. Prognostic factors in severe exacerbation of chronic hepatitis B. Clin Infect Dis, 2003, 36(8): 979-984.
[13]	Zhang XQ,Jiang L,You JP, et al. Efficacy of short-term dexamethasone therapy in acute-on-chronic pre-liver failure. Hepatol Res, 2011, 41(1): 46-53.
[14]	Franchini M,Franchi M,Bergamini V, et al. A critical review on the use of recombinant factor Ⅶa in life-threatening obstetric postpartum hemorrhage. Semin Thromb Hemost, 2008, 34(1): 104-112.
[15]	Bomken C,Mathai S,Biss T, et al. Recombinant activated factor Ⅶ (rFⅦa) in the management of major obstetric haemorrhage: a case series and a proposed guideline for use. Obstet Gynecol Int, 2009: 364843.
[16]	Lee SW,Hong YS,Park DW, et al. Lactic acidosis not hyperlactatemia as a predictor of in hospital mortality in septic emergency patients. Emerg Med J, 2008, 25(10): 659-665.
[17]	Cusack RJ,Rhodes A,Lochhead P, et al. The strong ion gap does not have prognostic value in critically ill patients in a mixed medical/sugical adult ICU. Intensive Care Med, 2002, 28(7): 864-869.
[18]	晋茂生.妊娠期急性脂肪肝.中华全科医学, 2008, 6(10): 1098-1099.

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Analysis on the major clinical indicators in patients with acute fatty liver of pregnancy

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