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妊娠急性脂肪肝:中国南方32例回顾性研究

Acute fatty liver of pregnancy: a retrospective study of 32 cases in South China.

作者信息

Cheng Na, Xiang Tianxin, Wu Xiaoping, Li Ming, Xie Yao, Zhang Lunli

机构信息

Department of Infectious Diseases, the First Affiliated Hospital of Nanchang University, Nanchang, China and.

出版信息

J Matern Fetal Neonatal Med. 2014 Nov;27(16):1693-7. doi: 10.3109/14767058.2013.871704. Epub 2014 Jan 13.

Abstract

OBJECTIVE

To describe 32 cases of acute fatty liver of pregnancy (AFLP) and identify the potential clinical predictors of maternal and fetal outcomes in South China.

METHODS

Thirty-two cases of AFLP previously treated in the First Affiliated Hospital of Nanchang University in the past 10 years were enrolled in the current study.

RESULTS

Sex of fetus and delivery method was the potential clinical predictor of fetal outcome. The main manifestations of AFLP were jaundice (n = 32), nausea and vomiting (n = 28), malaise (n = 25), and ascites (n = 25), and its complications included acute renal failure (n = 26), hepatic encephalopathy (n = 17), infection (n = 10), and postpartum hemorrhage (n = 7). Evidence of fatty changes of liver was demonstrated by B ultrasound and computed tomography (CT). Eighteen patients were recovered due to rapid diagnosis, early termination of pregnancy and supportive treatments.

CONCLUSIONS

Male sex and vaginal delivery was the risk factor of fetal outcome. Detailed history taking and proper management of potential predictors are important in making the decision of prompt delivery and choosing the appropriate delivery method. Further studies are needed to expand our knowledge on this disease.

摘要

目的

描述32例妊娠急性脂肪肝(AFLP)病例,并确定中国南方地区母婴结局的潜在临床预测因素。

方法

本研究纳入了过去10年在南昌大学第一附属医院接受治疗的32例AFLP病例。

结果

胎儿性别和分娩方式是胎儿结局的潜在临床预测因素。AFLP的主要表现为黄疸(n = 32)、恶心和呕吐(n = 28)、不适(n = 25)和腹水(n = 25),其并发症包括急性肾衰竭(n = 26)、肝性脑病(n = 17)、感染(n = 10)和产后出血(n = 7)。肝脏脂肪变性的证据通过B超和计算机断层扫描(CT)得以证实。18例患者因诊断迅速、早期终止妊娠及支持治疗而康复。

结论

男性胎儿和阴道分娩是胎儿结局的危险因素。详细询问病史并对潜在预测因素进行适当管理,对于做出及时分娩的决策和选择合适的分娩方式非常重要。需要进一步研究以扩大我们对这种疾病的认识。

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