早期诊断妊娠期急性脂肪肝的5个核心标准

Five capital standard of early diagnosis of acute fatty liver of pregnancy

目的探讨妊娠期急性脂肪肝的临床特点，提高早期诊断水平。方法将2014年1月至2015年6月13例妊娠期急性脂肪肝患者的病例资料进行回顾性分析，分析入院时的临床表现、实验室检查和影像学检查。结果妊娠期急性脂肪肝患者同时存在妊娠晚期发病、上消化道症状、肝功能异常、凝血功能障碍和肾功能不全，而高血氨、高血尿酸、白细胞升高、低血糖和肝脏超声异常仅部分患者存在。结论妊娠晚期发病、上消化道症状、肝功能异常、凝血功能障碍和肾功能不全是妊娠期急性脂肪肝的5个核心诊断标准，把握这些特点才能早期诊断妊娠期急性脂肪肝，从而改善母儿结局。

Objective To investigate the clinical features of acute fatty liver of pregnancy, and to improve the early diagnosis. Methods The clinical data of 13 patients of acute fatty liver of pregnancy from January 2014 to June 2015 were retrospectively analyzed. Clinical manifest, chemical examination and imaging examination were analyzed. Results The lategestation, upper digestive tract symptom, liver, renal and blood clotting function abnormity were common characteristics of all patients of acute fatty liver of pregnancy, but heightened blood ammonia, blood uric acid and leukocytes or decreased blood glucose and ultrasonic sound abnormity appeared only in proportion of these patients. Conclusions Lategestation, upper digestive tract symptom, liver, renal and blood clotting function abnormity are five capital standard of early diagnosis of acute fatty liver of pregnancy; by knowing this, we can diagnose it early and improve the outcome.