妊娠期急性脂肪肝预后因素的Logistic回归分析

目的:探讨妊娠期急性脂肪肝(AFLP)患者的临床特征及其影响预后的危险因素。方法:回顾性分析AFLP患者40例,总结其临床特点,运用APACHEⅡ评分≥20为分界将预后分类,对其各项实验室指标进行单因素及多因素Logistic回归分析。结果:前驱症状出现时间、终止妊娠时间、血清肌酐、白细胞、活化部分凝血酶时间在预后中差异有统计学意义(P<0.05)。多因素回归分析结果显示活化部分凝血酶时间测定为妊娠期急性脂肪肝预后的危险因素。结论:临床AFLP有无特异前驱症状临床误诊率高,凝血功能变化后预后差,尽早就诊、早期诊断、及时终止妊娠是降低母儿死亡率的关键。

Logistic regression analysis on prognosis factors of acute fatty liver of pregnancy

Objective:To investigate the clinical feature,diagnosis and treatment of acute fatty liver of pregnancy(AFLP) and analyze the prognosis factors by logistic regression analysis.Methods:The clinical courses,laboratory findings and therapies of 40 AFLP patients during past thirteen years were retrospectively analyzed.APACHE Ⅱ grade system≥20 was used to be as the line for prognosis.Results of laboratory examination were analyzed by the single factor analysis and binary logistic regression.Results:Time of invasion to visiting,the time of coming to termination of pregnancy,serum creatinine,leukocyte,APTT had significant meaning for prognosis in single factor analysis,APTT was the dangerous factor for prognosis in binary logistic regression analysis.Conclusion:AFLP with or without specific prodrome has high clinic misdiagnosis rate.After coagulation function changing,prognosis is bad.To decrease mortality of mother and infant,it is key point to come early,diagnosis early,termination of pregnancy on maternal in time.