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关键词:子痫前期;肝功能;围产儿;并发症
英文关键词:
目的 探讨重度子痫前期孕妇肝功能异常程度对母胎结局的影响。方法 回顾性分析2015年 1月至2016年4月在重庆市巴南区人民医院产科住院治疗的子痫前期合并肝功能损害80例孕妇的临床资料,其中包括轻度子痫前期(轻度组)和重度子痫前期(重度组)孕妇各40例,收集同期住院正常孕妇40例(对照组)的临床资料,比较各组孕妇肝功能指标、妊娠结局和胎儿结局。结果 重度组丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、谷氨酰转肽酶(GGT)、碱性磷酸酶(ALP)高于轻度组,直接胆红素(DBIL)低于轻度组,差异均有统计学意义(均P<0.05)。重度组ALT、AST、GGT高于,ALP、白蛋白、总胆红素、DBIL低于对照组,差异均有统计学意义(均P<0.05)。轻度组ALP低于对照组,差异有统计学意义(P<0.05)。重度组剖宫产率、产后出血、HELLP综合征发生率明显高于轻度组和对照组[100.0%(40/40)比55.8%(22/40)、45.0%(18/40),7.5%(12/40)比2.5%(1/40)、5.0%(2/40),30.0%(12/40)比10.0%(4/40)、5.0%(2/40)],差异均有统计学意义(均P<0.05)。重度组胎儿生长受限、早产、胎儿窘迫、新生儿窒息及围产儿死亡的发生率明显高于轻度组和对照组[27.5%(11/40)比7.5%(3/40)、5.0%(2/40),62.5%(25/40)比35.0%(14/40)、32.5%(13/40),25.0%(10/40)比5.0%(2/40)、7.5%(3/40),52.5%(21/40)比12.5%(5/40)、15.0%(6/40),17.5%(7/40)比5.0%(2/40)、2.5%(1/40)],差异均有统计学意义(均P<0.05)。结论 重度子痫前期孕妇肝功能生化指标有明显改变,并严重影响妊娠的进展及胎儿的生长发育。
Influence of abnormal liver function on maternal and fetal outcomes in women with severe preeclampsia
Long Weidong, Zhu Genmiao, Huang Dongyue, Liu Feng
Department of Clinical Laboratory, Banan People′s Hospital of Chongqing, Chongqing 401320, China(Long WD, Zhu GM, Liu F); Department of Clinical Laboratory, West China Second University Hospital, Sichuan University, Chengdu 610041, China(Huang DY)
Corresponding author: Liu Feng, Email: 3057521810@qq.com
【Abstract】Objective To explore the influence of abnormal liver function on maternal and fetal outcomes in patients with severe preeclampsia. Methods Clinical data of 80 cases of preeclampsia complicated with liver function damage from January 2015 to April 2016 in Banan People′s Hospital of Chongqing were retrospectively analyzed, including 40 cases of mild preeclampsia(mild group) and 40 cases of severe preeclampsia(severe group); clinical data of 40 normal pregnant women were collected as control group. Liver function indexes, pregnant outcomes and fetal outcomes were analyzed. Results Levels of alanine aminotransferase(ALT), aspartate aminotransferase(AST), glutamyl transferase(GGT) and alkaline phosphatase(ALP) in severe group were significantly higher, and direct bilirubin(DBIL) was significantly lower than those in mild group(P<0.05). ALT, AST, GGT were significantly higher and ALP, albumin, total bilirubin, DBIL were significantly lower in severe group than those in control group(P<0.05). ALP in mild group was significantly lower than that in normal group(P<0.05). Rates of cesarean section, postpartum hemorrhage and HELLP syndrome in severe group were significantly higher than those in mild group and control group[100.0%(40/40) vs 55.8%(22/40), 45.0%(18/40); 7.5%(12/40) vs 2.5%(1/40), 5.0%(2/40); 30.0%(12/40) vs 10.0%(4/40), 5.0%(2/40)](P<0.05). Rates of fetal growth restriction, premature delivery, fetal distress, neonatal asphyxia and perinatal death in severe group were significantly higher than those in mild group and control group[27.5%(11/40) vs 7.5%(3/40), 5.0%(2/40); 62.5%(25/40) vs 35.0%(14/40), 32.5%(13/40); 25.0%(10/40) vs 5.0%(2/40), 7.5%(3/40); 52.5%(21/40) vs 12.5%(5/40), 15.0%(6/40); 17.5%(7/40) vs 5.0%(2/40), 2.5%(1/40)](P<0.05). Conclusion Abnormal liver function of severe preeclampsia has adverse influence on pregnancy progress and fetal growth.
【Key words】Preeclampsia;Liver function;Perinatal;Complications
【Fund program】National High Technology Research and Development Program of China (863 Program)(2015AA020110)
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