妊娠期急性脂肪肝发病机制的多因素性

An Overview on Multiple Pathogenesis of Acute Fatty Liver of Pregnancy

妊娠期急性脂肪肝是发生于妊娠晚期的一种严重并发症,其发病原因迄今不明。临床表现复杂,起病急骤,病情凶险,孕产妇及围生儿病死率高。既往研究表明,发病主要与胎儿线粒体脂肪酸代谢障碍(FAOD)有关。近年研究发现,除与长链3-羟基辅酶A脱氢酶(LCHAD)缺乏有关外,与中短链脂肪酸缺乏、母亲或胎儿各类基因片段的变异缺失、氧化应激反应导致毒物堆积、病毒细菌螺旋体等微生物感染、激素水平和体质量指数改变等多种因素相关,呈多因素异质性。

Acute fatty liver of pregnancy （AFLP） is a serious complication in the late stage of gestation,which has complicated clinical manifestation with onset suddenly.It has serious maternal and perinatal mortality rate.The pathogenesis is not clear until now,since previous researches indicate that its outbreak mainly link to fatty acid oxidation deficiency （FAOD）.Recent years researches express its etiology not only relate with long-chain 3 hydroxyacylCOA dehydrogenase （LCHAD）,but also with integrated factors like shortage of short or medium-chain acyl-CoA dehydrogenase,variable or imperfect gene part of the mother and fetus,the accumulation of toxic caused by oxidative stress,the microbial infection including the germ helicoids and virus,hormone shift,the body mass index （BMI） and nutritional conditions change etc.All the various factors can relate and affect each other and present many different natures.