妊娠期暴发型肝功能衰竭的研究

目的探讨妊娠期暴发型肝功能衰竭(FHFP)的临床，生化，病原学特点。方法观察21例FHFP临床表现，并分析实验室资料，13例作肝组织学检查。结果乙型肝炎病毒感染7例，乙型肝炎病毒、戊型肝炎病毒重叠感染2例。FHFP血清白蛋白极显著低于妊娠期急性肝炎和慢性肝炎，分别为(25.19±6．95)、(33．17±3．44)及(33．80±3．78)g/L(均P＜0.01)。肝组织学诊断为，存活的6例中，急性肝炎1例，慢性肝炎4例，瘀胆型肝炎1例。死亡7例中，慢性肝炎4例，瘀胆型肝炎2例，产前子痫肝损害1例。结论肝炎病毒是FHFP的病因之一。低蛋白血症在FHFP发病中起着重要作用；FHFP可能是一种独特的综合征。

Study on fulminant hepatic failure during pregnancy

Objective To study the clinical, biochemical and serological profiles of fulminant hepatic failure during pregnancy (FHFP).Methods Clinical and laboratory data were analyzed in 21 patients with FHFP. Hepatic biopsies were undertaken in 13 cases.Results The results of serologic tests showed that 7 cases were infected by hepatitis B alone and other 2 cases were superinfected with hepatitis B and hepatitis E virus. Results of liver function tests showed levels of serum albumin in FHFP patients were significantly lower than those in the patients with chronic hepatitis and acute hepatitis during pregnancy (both P < 0.01 ). Seven died patients were histopathologically diagnosed as chronic hepatitis in 4, cholestatic hepatitis in 2, and pre eclampsia induced liver lesion in 1 respectively. Among 6 surviviors, 1 acute hepatitis, 4 chronic hepatitis and 1 cholestatic hepatitis were found.Conclusion Hepatitis virus is one of etiological factors contributing to FHFP. Severe hypoalbuminemia may play an important role in the pathogenesis of FHFP. FHFP may be defined as an unique syndrome in the infections of hepatitis virus.