文章摘要

100例妊娠期肝功能异常患者的临床分析

作者: 1支艳俊
1 北京市通州区妇幼保健院内科,北京 101101
通讯: 支艳俊 Email: 28727109@qq.com
DOI: 10.3978/j.issn.2095-6959.2022.04.011

摘要

目的:探讨妊娠期肝功能异常的病因、临床特点及母婴结局。方法:选取2018年1月至2021年1月北京市通州区妇幼保健院接收的妊娠期肝功能异常患者100例设为观察组,选取同期于北京市通州区妇幼保健院接受产检的肝功能正常孕妇100例设为对照组,对比分析两组的肝功能指标及妊娠结局。结果:观察组的谷丙转氨酶(alanine aminotransferase,ALT)、谷草转氨酶(aspartate aminotransferase,AST)、总胆红素(total bilirubin,TBIL)、总胆汁酸(total bile acid,TBA)水平显著高于对照组,白蛋白(albumin,ALB)水平比对照组低(P<0.05);在观察组100例患者中,妊娠早中期者占71.00%,妊娠晚期者占29.00%,妊娠晚期者的ALT、AST、TBIL、TBA水平显著高于妊娠早中期者,且ALB水平较妊娠早中期者低(P<0.05);观察组的肝功能异常原因主要为药物性肝炎(46.00%),不同引发原因患者ALT、AST、TBIL、TBA水平均存在明显异常;观察组的不良妊娠结局发生率是13.00%,显著高于对照组的4.00%(P<0.05)。结论:妊娠期肝功能异常患者多发生在妊娠早中期;妊娠晚期肝功能异常的程度较妊娠早中期者高。妊娠早中期肝功能异常主要原因为药物性肝炎;妊娠期肝功能异常可增大不良妊娠结局风险。
关键词: 妊娠期肝功能异常;妊娠并发症;病因;临床特点;母婴结局

Clinical analysis of 100 patients with abnormal liver function during pregnancy

Authors: 1ZHI Yanjun
1 Department of Internal Medicine, Tongzhou Maternal & Child Health Hospital of Beijing, Beijing 101101, China

CorrespondingAuthor: ZHI Yanjun Email: 28727109@qq.com

DOI: 10.3978/j.issn.2095-6959.2022.04.011

Abstract

Objective: To investigate the etiology, clinical features and maternal and infant outcomes of abnormal liver function during pregnancy. Methods: A total of 100 patients with abnormal liver function during pregnancy accepted by Tongzhou Maternal & Child Health Hospital of Beijing from January 2018 to January 2021 were selected as the observation group, 100 cases of pregnant women with normal liver function who underwent a check-up in our hospital during the same period were selected as the control group, and the liver function indexes and pregnancy outcome of the two groups were compared. Results: In the observation group, the levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), and total bile acid (TBA) were higher than the control group, and the albumin (ALB) level was lower than the control group (P<0.05). Among the 100 patients in the observation group, 71.00% were in the early and second trimester and 29.00% were in the third trimester. The levels of ALT, AST, TBIL and TBA in the third trimester of pregnancy were significantly higher than those in the first and second trimesters of pregnancy, and the levels of ALB were low in the first and second trimesters of pregnancy (P<0.05).The main cause of abnormal liver function in the observation group was drug-induced hepatitis (46.00%), and the levels of ALT, AST, TBIL, and TBA in patients with different causes were obviously abnormal. In the observation group, the incidence of adverse pregnancy outcomes was 13.00%, which was higher than 4.00% in the control group (P<0.05). Conclusion: The related liver function indexes of patients with abnormal liver function during pregnancy are obviously abnormal, and they are mostly concentrated in the first and second trimester. The degree of abnormal liver function in the third trimester is higher than that in the early and mid-gestation period. The main cause is drug-induced hepatitis. The abnormal liver function can increase risk of adverse pregnancy outcome during pregnancy.
Keywords: abnormal liver function during pregnancy; pregnancy complications; etiology; clinical features; maternal and infant outcome