不明原因的妊娠期肝功能损害危险因素分析

Risk factors of hepatic dysfunction with unknown cause during gestational period

目的分析不明原因的妊娠期肝功能损害的危险因素。方法回顾性选取不明原因的妊娠期肝功能损害孕妇203例(研究组),另选取同期常规产检的正常孕妇200例为对照组。比较两组入院时首次测得的肝功能指标[ALT、AST、TBil、γ-谷氨酰基转肽酶(γ-GT)水平等],比较两组临床资料(BMI、受教育程度、是否被动吸烟、是否多胎妊娠、是否常年居于本地、是否为流动人口、既往产次等),并分析不明原因的妊娠期肝功能损害的危险因素。结果研究组孕妇入院时首次测得的ALT、AST、TBil、γ-GT水平均高于对照组(均P<0.05)。研究组孕妇BMI、被动吸烟率均明显高于对照组(均P<0.05),受教育程度、是否多胎妊娠、是否常年居于本地、是否流动人口、既往产次等方面与对照组比较差异均无统计学意义(均P>0.05)。多因素分析显示,高BMI、被动吸烟是不明原因的妊娠期肝功能损害的独立危险因素(均P<0.05)。结论不明原因的妊娠期肝功能损害的发生可能与高BMI、被动吸烟有关,因此做好孕前及孕期体重管理、纠正不良生活习惯,有利于预防风险。

Objective The analyze the risk factors of hepatic dysfunction with unknown cause during gestational period.Methods Two hundred and three pregnant women with hepatic dysfunction of unknown cause(study group)and200pregnant women with normal liver function(control group)were enrolled in the study.The liver function indicators ALT,AST,TBil,γ-GT were measured and the clinical data and pregnant history were compared between two groups.The risk factors for the hepatic dysfunction with unknown cause in pregnancy were analyzed.Results The ALT,AST,TBil andγ-GT levels in the study group were all higher than those in control group(all P<0.05).The BMI and passive smoking rate were significantly higher in study group than those in control group(all P<0.05),while there were no significant differences in educational levels,history of pregnancy and other factors between two groups(P>0.05).Multivariate analysis showed that high BMI and passive smoking were independent risk factors(all P<0.05)for hepatic dysfunction in pregnant women.Conclusion The occurrence of hepatic dysfunction with unknown cause during gestational period may be related to high BMI and passive smoking.