【摘要】 目的:探讨妊娠期孕妇肝功能异常的病因、发生率以及对妊娠结局的影响。方法:分析2003～2004年4217例孕妇肝功能测试(ALT、AST、GGT、TBIL)结果,对肝功能异常孕妇追踪观察整个孕期及产后1周。结果:14个月中有4217例孕产妇进行了肝功能测试,发现95例肝功能异常。其中由妊娠相关因素引起的肝功能异常有44例(占46.32%),非妊娠特异因素引起的肝功能异常有23例(占24.21%),28例孕妇(29.47%)肝酶暂时升高原因未明。95例肝功能异常孕妇的临床诊断主要包括:妊娠剧吐11例,妊娠高血压综合征21例,母儿ABO血型不合10例,妊娠期糖尿病2例;甲、丙型肝炎各1例,乙型肝炎18例,上呼吸道感染2例。与妊娠相关的肝酶异常发生在孕中期(20.00%)和孕晚期(17.89%)相对多于孕早期(8.42%)。妊娠高血压综合征、乙型肝炎、妊娠剧吐,是引起妊娠期肝功能异常的主要病因。观察期内无一例孕妇死亡。结论:妊娠期肝功能异常的原因复杂多样,部分孕妇可有肝酶无特异性的短暂升高。由妊娠相关因素引发的肝功能异常的孕妇其转氨酶(ALT)在产后迅速恢复。更多还原

【Abstract】 Objective:To study the incidence, causes and outcome of liver dysfunction in pregnancy.Methods:Liver function test (ALT, AST, GGT, TBIL) of 4 217 from 2003 to 2004 were analyzed to assess and follow throughout the patients with abnormal liver tests until one week after pregnancy.Results:4 217 pregnant women were collected during 14 months.Of them 95 patients had abnormal liver tests, including 44 (46.32%) cases associated with pregnancy, 23 (24.21%) cases unrelated to pregnancy, 28 (29.547%) cases with temporary liver enzyme increase for unknown etiology.Their presenting symptoms included hyperemesis gravidarum (11), pregnancy induced hypertension (PIH) (21), ABO maternal-fetal incompatible (10), gestational diabetes mellitus (2), hepatitis A flare (1), hepatitis C flare (1),hepatitis B flare (18), superior respiratory tract infection (2).Abnormal liver function tests occurred more frequently in the second (20.00%) and third (17.89%) trimesters than those in the first trimester (8.42%).PIH, hepatitis B and hyperemesis gravidarum were the commonest causes of abnormal liver tests in pregnancy.There were no maternal death related to liver dysfunction during the 14 months study.Conclusion:The causes of abnormal liver function tests in pregnancy are varied , some cases of them have temporary liver enzyme increase for unknown etiology.Liver dysfunction is usually directly related to pregnancy with spontaneous recovery in the puerperium..更多还原