95例妊娠肝功能异常回顾性分析  

Retrospective analysis of 95 cases of abnormal liver function in pregnancy

作　　者：梁绮华[1] 邱先桃[1] 丘媛媛[1] 杨红玲[1] 

机构地区：[1]广东省广州市妇婴医院检验科,510180

出　　处：《中国妇幼保健》2006年第16期2217-2219,共3页Maternal and Child Health Care of China

摘　　要：目的:探讨妊娠期孕妇肝功能异常的病因、发生率以及对妊娠结局的影响。方法:分析2003～2004年4217例孕妇肝功能测试(ALT、AST、GGT、TBIL)结果,对肝功能异常孕妇追踪观察整个孕期及产后1周。结果:14个月中有4217例孕产妇进行了肝功能测试,发现95例肝功能异常。其中由妊娠相关因素引起的肝功能异常有44例(占46.32%),非妊娠特异因素引起的肝功能异常有23例(占24.21%),28例孕妇(29.47%)肝酶暂时升高原因未明。95例肝功能异常孕妇的临床诊断主要包括:妊娠剧吐11例,妊娠高血压综合征21例,母儿ABO血型不合10例,妊娠期糖尿病2例;甲、丙型肝炎各1例,乙型肝炎18例,上呼吸道感染2例。与妊娠相关的肝酶异常发生在孕中期(20.00%)和孕晚期(17.89%)相对多于孕早期(8.42%)。妊娠高血压综合征、乙型肝炎、妊娠剧吐,是引起妊娠期肝功能异常的主要病因。观察期内无一例孕妇死亡。结论:妊娠期肝功能异常的原因复杂多样,部分孕妇可有肝酶无特异性的短暂升高。由妊娠相关因素引发的肝功能异常的孕妇其转氨酶(ALT)在产后迅速恢复。Objective： To study the incidence, causes and outcome of liver dysfunction in pregnancy. Methods： Liver function test （ALT, AST, GGT, TBIL） of 4217 from 2003 to 2004 were analyzed to assess and follow throughout the patients with abnormal liver tests until one week after pregnancy. Results： 4 217 pregnant women were collected during 14 months. Of them 95 patients had abnormal llver tests, including 44 （46. 32% ） cases associated with pregnancy, 23 （24.21%） cases unrelated to pregnancy, 28 （29. 547% ） cases with temporary liver enzyme increase for unknown etiology. Their presenting symptoms included hyperemesis gravidarum （ 11 ）, pregnancy induced hypertension （PIH） （ 21 ）, ABO maternal - fetal incompatible （ 10）, gestational diabetes mellitus （ 2 ）, hepatitis A flare （ 1 ）, hepatitis C flare （ 1 ）, hepatitis B flare （18） , superior respiratory tract infection （2） . Abnormal liver function tests occurred more frequently in the second （20.00%） and third （ 17.89% ） trimesters than those in the first trimester （8.42%） . PIH, hepatitis B and hyperemesis gravidarum were the commonest causes of abnormal liver tests in pregnancy. There were no maternal death related to liver dysfunction during the 14 months study. Conclusion： The causes of abnormal liver function tests in pregnancy are varied , some cases of them have temporary liver enzyme increase for unknown etiology. Liver dysfunction is usually directly related to pregnancy with spontaneous recovery in the puerperium.

关 键 词：妊娠 肝功能测试 妊娠高血压综合征 乙型肝炎 

分 类 号：R714[医药卫生—妇产科学]