妊娠期急性脂肪肝与HELLP综合征的临床特点比较及预后特点  

Comparison of clinical characteristics and prognostic features between acute fatty liver during pregnancy and HELLP syndrome

作　　者：韩冠亚 孙慧聪 HAN Guanya;SUN Huicong(Ningbo Women&Children's Hospital,Ningbo 315012,China)

机构地区：[1]宁波市妇女儿童医院,浙江宁波315012

出　　处：《中国现代医生》2022年第12期16-19,46,共5页China Modern Doctor

基　　金：浙江省宁波市科技计划项目(2019A610312)。

摘　　要：目的探讨妊娠期急性脂肪肝(AFLP)与HELLP综合征的临床及实验室特点,为临床在两种疾病的诊断及治疗方面提供更精准的资料。方法回顾性分析2010年1月至2020年12月入住宁波市妇女儿童医院重症监护病房分娩的产妇,收集其临床资料,其中AFLP产妇21例作为观察组,同期随机抽取诊断为HELLP综合征的产妇24例作为对照组。对两组产妇的一般情况、主诉、实验室及辅助检查等进行对比分析。结果观察组和对照组在总胆红素(TBIL)、直接胆红素(DBIL)、清蛋白(ALB)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、血肌酐(Cr)、凝血酶原时间(PT)、部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、国际标准化比值(INR)、白细胞计数(WBC)方面比较,差异有统计学意义(P<0.05),且新生儿性别为男性与对照组相比,差异有统计学意义(P<0.05),但在主诉、一般情况、乙型肝炎病毒携带等方面组间比较,差异无统计学意义(P>0.05)。结论早诊断、适时终止妊娠、对症治疗是处理AFLP的重点。临床上在实验检查方面,急性脂肪肝更注重胆红素及凝血功能方面的异常。Objective To explore the clinical and laboratory characteristics of acute fatty liver during pregnancy(AFLP)and HELLP syndrome,to provide more accurate clinical data for the diagnosis and treatment of the two diseases.Methods A retrospective analysis of clinical data of parturients admitted to the intensive care unit of our hospital from January 2010 to December 2020 was conducted.The observation group included 21 parturients with AFLP,and the control group included 24 randomly selected parturients with HELLP syndrome during the same period.The general conditions,chief complaints,and laboratory and auxiliary examinations were compared between the two groups.Results There were significant differences in total bilirubin(TBIL),direct bilirubin(DBIL),albumin(ALB),total cholesterol(TCHO),triglycerides(TG),high-density lipoprotein(HDL),low-density lipoprotein(LDL),blood creatinine(Cr),prothrombin time(PT),partial thromboplastin time(APTT),fibrinogen(FIB),international normalized ratio(INR),and white blood cell count(WBC)between the observation group and the control group(P<0.05).There was a significant difference in proportion of male newborns between the observation group and the control group(P<0.05).There were no significant differences in chief complaints,general conditions,and hepatitis Bvirus carrying between the two groups(P>0.05).Conclusion Early diagnosis,timely termination of pregnancy,and symptomatic treatment are the key points in dealing with AFLP.In terms of clinical laboratory examinations,we should pay more attention to the abnormalities of bilirubin and coagulation function in acute fatty liver.

关 键 词：妊娠期急性脂肪肝 HELLP综合征 妊娠期并发症 急诊处理 

分 类 号：R575.5[医药卫生—消化系统]