妊娠期急性脂肪肝临床特征及预后不良相关因素研究

Study on the Clinical Characteristics of Acute Fatty Liver During Pregnancy and the Related Factors of Poor Prognosis

目的分析妊娠期急性脂肪肝患者的临床特征以及预后不良的相关因素。方法随机选取该院于2018年5月—2019年5月,此1年时间段内收治的44例患者作为此次研究对象,将其根据最终临床结局分组,分为观察组(36例,治疗后并未出现患者或新生儿死亡情况)与对照组(8例,治疗后存在患者或新生儿死亡情况)。对两组患者实施将两组患者临床特征以及各相关因素互相比对,分析影响患者预后不良的因素。结果经研究结果显示,观察组患者ALT(191.66±47.37)U/L、AST(223.48±53.71)U/L、DBIL(91.35±22.46)μmol/L、PT(16.27±3.81)s水平明显低于照组患者(296.48±37.97)U/L、(284.41±43.33)U/L、(150.15±33.82)μmol/L、(25.48±3.98)s,两组之间差异有统计学意义(t=5.838、2.991、6.086、6.138,P<0.05)。临床特征比较显示,观察组患者患有妊娠期糖尿病52.8%、宫缩乏力36.1%较对照组患者的12.5%、0.0%更高,患有弥散性血管内凝血36.1%数远较对照组75.0%更低,两组差异有统计学意义(χ^2=4.283、4.100、4.035,P<0.05)。结论妊娠期急性脂肪肝患者临床常表现为可并发多种疾病,如妊娠期糖尿病、宫缩乏力、弥散性血管内凝血等,患者预后不良则主要与其胆红素水平、总蛋白水平、内纤维蛋白原水平、谷丙转氨酶水平、谷草转氨酶水平、凝血酶原时间有关。此次研究样本数较少,仍需在后续研究中,提高样本数量,得到更为准确的研究结果。

Objective To analyze the clinical characteristics of patients with acute fatty liver during pregnancy and related factors of poor prognosis.Methods 44 patients admitted in the hospital from May 2018 to May 2019 were randomly selected as the research object,and they were divided into observation group(36 cases,treatment group,according to the final clinical outcome,no patient or neonatal death occurred afterwards)and the control group(8 cases,patients or neonatal deaths occurred after treatment).The clinical characteristics and related factors of the two groups of patients were compared with each other,and the factors affecting the poor prognosis of the patients were analyzed.Results The results of the study showed that the levels of ALT(191.66±47.37)U/L,AST(223.48±53.71)U/L,DBIL(91.35±22.46)μmol/L,and PT(16.27±3.81)s in the observation group were significantly lower than those in the control group of(296.48±37.97)U/L,(284.41±43.33)U/L,(150.15±33.82)μmol/L,(25.48±3.98)s,the differences between the two groups were statistically significant(t=5.838,2.991,6.086,6.138,P<0.05).Comparison of clinical characteristics showed that patients in the observation group had 52.8%of gestational diabetes mellitus and 36.1%of uterine insufficiency,which was higher than 12.5%and 0.0%of patients in the control group,and 36.1%of patients with diffuse intravascular coagulation were far more than 75.0%in the control group.The difference was statistically significant between the two groups(χ^2=4.283,4.100,4.035,P<0.05).Conclusion Patients with acute fatty liver during pregnancy often present with multiple diseases,such as gestational diabetes,uterine fatigue,and diffuse intravascular coagulation.The poor prognosis of patients is mainly related to their bilirubin level,total protein level,and internal fiber.Protein levels,alanine aminotransferase levels,aspartate aminotransferase levels,and prothrombin time are related.The number of samples in this study is small,and it is still necessary to increase the sample size in subsequent studies to obtain more accurate research results.