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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2 1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 (2 5 .19± 6 .95 )、(33.17± 3.44 )及 (33.80± 3.78) g/L(均P <0 .0 1)。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
Objective To investigate the clinical, biochemical and etiological characteristics of fulminant hepatic failure (FHFP) during pregnancy. Methods 21 cases of FHFP clinical manifestations, and laboratory data analysis, 13 cases of liver histology. Results Hepatitis B virus infection in 7 cases, hepatitis B virus, hepatitis E virus overlap in 2 cases. FHFP serum albumin was significantly lower than that of acute hepatitis and chronic hepatitis during pregnancy, and were (25.19 ± 6.95), (33.17 ± 3.44) and (33.80 ± 3.78) g / L, respectively 1). Histological diagnosis of liver, 6 cases of survival, acute hepatitis in 1 case, 4 cases of chronic hepatitis, bruising hepatitis in 1 case. Among the 7 deaths, 4 were chronic hepatitis, 2 were stasis-type hepatitis and 1 was pre-eclamptic liver damage. Conclusion Hepatitis A virus is one of the causes of FHFP. Hypoproteinemia plays an important role in the pathogenesis of FHFP; FHFP may be a unique syndrome