妊娠期急性脂肪肝患者的主要临床检验指标分析

Analysis on the major clinical indicators in patients with acute fatty liver of pregnancy

目的探讨妊娠期急性脂肪肝患者的主要临床检验指标变化特点。方法回顾性研究2009年3月至2013年8月在中山大学附属第三医院接受诊治的26例妊娠期急性脂肪肝患者临床资料。根据患者临床结局分为好转组与未好转组。好转组20例,年龄18～30岁,中位年龄25岁;未好转组6例,年龄20～29岁,中位年龄24岁。所有患者均签署知情同意书,符合医学伦理学规定。观察两组患者转入重症监护病房(ICU)24 h外周静脉血总胆红素(TB)、凝血酶原活动度(PTA)、血清肌酐(Scr)、空腹血糖(FPG)和动脉血乳酸(Lac)等主要临床检验指标的差异。两组患者主要临床检验指标的比较采用t检验。结果好转组转入ICU 24 h TB、PTA、Scr、FPG、Lac分别为(193±99)μmol/L、(48±17)%、(114±84)μmol/L、(5.7±2.9)mmol/L、(2.8±1.0)mmol/L,未好转组分别为(259±119)μmol/L、(37±14)%、(161±79)μmol/L、(4.7±2.6)mmol/L、(3.9±1.5)mmol/L,两组患者相应指标比较差异有统计学意义(t=-8.178,8.231,-11.913,7.541,-10.032;P<0.05)。结论妊娠期急性脂肪肝患者TB、PTA、Scr、FPG、Lac等主要临床检验指标异常,预后差者其异常更为明显。

Objective To investigate the characteristics of major clinical indicators changes in patients with acute fatty liver of pregnancy. Methods Clinical data of 26 patients with acute fatty liver of pregnancy from March 2009 to August 2013 in the Third Affiliated Hospital of Sun Yat-sen University were analyzed retrospectively. According to the clinical outcome, patients were divided into improvement group （n=20, 18-30 years old, median age of 25 years old） and no-improvement group （n=6, 20-29 years old, median age of 24 years old）. The informed consents of all patients were obtained and the ethical committee approval was received. The differences of major clinical indicators such as total hilirubin （TB）, prothrombin time activity （PTA）, serum creatinine （Scr）, fasting blood glucose （FPG） of peripheral venous blood and arterial lactic acid （Lac） in patients of two groups were observed at 24 h after transferred into the intensive care unit （ICU）. The major clinical indicators in patients of two groups were compared by t test. Results The TB, PTA, Scr, FPG, Lac were （193＋99）txmol/L, （48±17）%, （114±84）μmol/L, （5.7±2.9）mmo1/L, （2.8±1.0）mmo]/L respectively in improvement group 24 h after transferred into ICU,and were （259±119） μmol/L （37±14）%, （161±79）μmol/L, （4.7±2.6）mmol/L, （3.9±1.5）mmol/L respectively in no-improvement group, wheresignificant differences were observed in the corresponding indexes between two groups（t=-8.178, 8.231, -11.913, 7.541, -10.032; P〈0.05）. Conclusions The major clinical indicators such as TB, PTA, Scr, FPG, Lac in patients with acute fatty liver of pregnancy are abnormal. It is even obvious in patients with poor prognosis.