Acute fatty liver of pregnancy: Over six months follow-up study of twenty-five patients
Acute fatty liver of pregnancy: Over six months follow-up study of twenty-five patients
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DOI：
10.3748/wjg.v21.i6.1927
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发表时间：
2015-02-14
影响因子：
4.3
通讯作者：
Li, Xing-Wang
中科院分区：
文献类型：
--
作者：
Xiong, Hao-Feng;Liu, Jing-Yuan;Li, Xing-Wang
目的：评估妊娠期急性脂肪肝（AFLP）患者出院后6个月及以上的预后。方法：回顾2012年11月北京地坛医院诊断为AFLP的妊娠患者16年的记录，对患者进行腹部超声、肝肾功能、血常规检查等监测。结果：研究期间共有42例确诊为AFLP，并对25例进行随访。平均随访时间为 54.5 个月（范围：6.5-181 个月）。所有患者身体状况良好，但1名患者患有妊娠糖尿病。所有患者康复后肾功能和肝功能均恢复正常，包括那些先前存在肝功能或肾功能衰竭的患者。 12 名患者的超声检查结果正常，10 名患者的超声回声图案逐渐变粗，肝脏回声增强，3 名患者出现轻度至中度脂肪肝浸润。所有患者均未出现肝硬化或肝结节。结论：AFLP患者的急性肝功能衰竭和急性肾功能衰竭是可逆的。如果患者的肝功能测试已正常化且状况良好，则 AFLP 康复后，患者不需要任何特定的长期随访。
AIM: To evaluate the prognosis of patients with acute fatty liver of pregnancy (AFLP) 6 mo or longer after discharge.METHODS: The records of pregnant patients diagnosed with AFLP at Beijing Ditan Hospital over a 16-year period were reviewed in November 2012. Patients were monitored using abdominal ultrasound, liver and kidney functions, and routine blood examination.RESULTS: A total of 42 patients were diagnosed with AFLP during the study period, and 25 were followed. The mean follow-up duration was 54.5 mo (range: 6.5-181 mo). All patients were in good physical condition, but one patient had gestational diabetes. The renal and liver functions normalized in all patients after recovery, including in those with pre-existing liver or kidney failure. The ultrasound findings were normal in 12 patients, an increasingly coarsened echo-pattern and increased echogenicity of the liver in 10 patients, and mild to moderate fatty liver infiltration in 3 patients. Cirrhosis or liver nodules were not observed in any patient.CONCLUSION: Acute liver failure and acute renal failure in AFLP patients is reversible. Patients do not require any specific long-term follow-up after recovery from AFLP if their liver function tests have normalized and they remain well.