妊娠期急性脂肪肝患者预后并发症发生影响因素及预测  

Influencing factors of the complications of pregnant women with acute fatty liver during pregnancy and their predictive values

作　　者：毛建娜[1] 魏小娟[1] 段花玲 高琦[1] MAO Jianna;WEI Xiaojuan;DUAN Hualing;GAO Qi(Xinxiang Central Hospital,Xinxiang,Henan Province,453000)

机构地区：[1]河南省新乡市中心医院,453000

出　　处：《中国计划生育学杂志》2024年第7期1682-1686,1691,共6页Chinese Journal of Family Planning

摘　　要：目的:探究妊娠期急性脂肪肝(AFLP)患者预后并发症发生影响因素。方法:回顾性收集2020年1月-2023年10月本院收治的153例AFLP患者临床资料,收集患者基本信息、血液学指标及急性生理和慢性健康评估系统(APACHEⅡ)评分,剖宫产术后随访6个月,采用比例风险模型分析AFLP患者预后发生并发症影响因素;绘制受试者工作特征(ROC)曲线,评价影响因素预测AFLP患者预后发生并发症性能。结果:AFLP患者剖宫产术后发生并发症23.5%(36/153);多因素回归分析,发病至就诊时间、总胆红素、凝血酶原时间和APAC均是AFLP患者预后发生并发症的独立影响因素;ROC曲线分析,发病至就诊时间(AUC=0.712)、总胆红素(AUC=0.741)、凝血酶原时间(AUC=0.734)、APACHEⅡ评分(AUC=0.758)及4项联合(AUC=0.906)预测AFLP患者预后发生并发症均有一定效能。结论:发病至就诊时间长、总胆红素水平高、凝血酶原时间大与APACHEⅡ评分高均为AFLP患者预后发生并发症的独立影响因素,4种因素预测AFLP患者预后发生并发症有一定价值。Objective: To explore the influencing factors of the complications of pregnant women with acute fatty liver during pregnancy(AFLP). Methods: The clinical data of 153 pregnant women with AFLP admitted to the hospital from January 2020 to October 2023 were collected retrospectively. The basic information, the hematology indexes values and the score of acute physiology and chronic health evaluation Ⅱ(APACHEⅡ) of the women were collected. The women with cesarean section were followed up for 6 months after surgery. Proportional risk model was used to analyze the factors affecting the complications of the pregnant women with AFLP. Receiver operating characteristic(ROC) curve was drawn to evaluate the efficacy of these influencing factors for predicting the complications of the women with AFLP. Results: The incidence of the postoperative complications of the women with AFLP was 23.5%(36/153). Multiariable regression analysis showed that the time from AFLP onset to visiting the hospital, the total bilirubin value, and the increased prothrombin time and APACHE Ⅱ score of the women were all the independent factors affecting their complications. ROC curve analysis showed that the time of AFLP onset to visiting the hospital(AUC=0.712), the total bilirubin value(AUC=0.741), the prothrombin time(AUC=0.734), the APACHEⅡ score(AUC=0.758), and the combination of the time from AFLP onset to visiting the hospital, the total bilirubin value and the increase of prothrombin time and APACHE Ⅱ score(AUC=0.906) of the women with AFLP had certain efficacy for predicting their complications. Conclusion: The longer time from AFLP onset to visiting the hospital, the high value of total bilirubin, and the increased prothrombin time and APACHE Ⅱ score of the women with AFLP are all the independent influencing factors of their complications, and all of these four influencing factors have certain efficacy for predicting the complications of the pregnant women with AFLP.

关 键 词：妊娠期急性脂肪肝 并发症 影响因素 预测 

分 类 号：R714.255[医药卫生—妇产科学]