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摘要：
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摘要：目的 探讨影响妊娠急性脂肪肝（acute fatty liver of pregnancy，AFLP）患者治愈
时间的危险因素。方法 对2004年1月至2019年11月首都医科大学附属北京地坛医院收治
的38例AFLP患者进行回顾性分析，根据纳入排除标准，最终纳入35例患者。根据治愈
时间将患者分为治愈时间≤ 14 d组（17例）和治愈时间＞ 14 d组（18例）。记录患者
的年龄、孕周、分娩男胎、子痫前期、急性肾功能不全、心功能不全、感染、肝性脑
病、肝衰竭、产后出血、凝血酶原活动度（prothrombin time activity，PTA）＜ 50%及低血
糖等临床资料。采用多因素Logistic回归分析影响AFLP患者治愈时间的危险因素。结
果 单因素分析表明，治愈时间≤ 14 d组和治愈时间＞ 14 d组患者男胎分娩（9例 vs 11
例）、子痫前期（4例 vs 8例）、急性肾功能不全（11例 vs 12例）、低血糖（7例 vs 9
例）及肝性脑病（1例 vs 2例）等差异无统计学意义（P均＞ 0.05），产后出血（3例 vs
10例；P = 0.035）、PTA ＜ 50%（2例 vs 13例；P < 0.001）、肝衰竭（1例 vs 10例；
P = 0.003）及感染（1例 vs 10例；P = 0.003）差异有统计学意义。多因素Logistic回归
分析表明，感染是影响AFLP患者治愈时间的独立危险因素（OR = 23.692，95%CI：
1.550～362.662，P = 0.023）。结论 感染是影响AFLP患者治愈时间的危险因素，在救
治过程中，有效预防感染是患者快速恢复、缩短病程的关键。
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Abstract: Objective To investigate the risk factors of cure time of patients with acute
fatty liver of pregnancy (AFLP). Methods The clinical data of 38 patients with AFLP in
Beijing Ditan Hospital, Capital Medical University from January 2004 to November 2019
were retrospectively analyzed. A total of 35 patients were eventually included based on
inclusion criteria. The patients were divided into cure time ≤ 14 d group (17 cases) and cure
time ＞ 14 d group (18 cases). Clinical data including age, gestational weeks, male fetuses,
preeclampsia, acute renal insufficiency, cardiac insufficiency, infection, hepatic encephalopathy,
postpartum hemorrhage, prothrombin time activity (PTA) ＜ 50% and hypoglycemia of the
patients were recorded. The risk factors of cure time in patients with AFLP were analyzed by
multivariate Logistic regression analysis. Results Univariate analysis showed that there were no
statistically significant differences in male fetuses (9 cases vs 11 cases), preeclampsia (4 cases
vs 8 cases), acute renal insufficiency (11 cases vs 12 cases), hypoglycemia (7 cases vs 9 cases)
and hepatic encephalopathy (1 case vs 2 cases) between patients in cure time ≤ 14 d group
and cure time ＞ 14 d group (all P ＞ 0.05), while there were statistically significant differences
in postpartum hemorrhage (3 cases vs 10 cases; P = 0.035), PTA ＜ 50% (2 cases vs 13 cases;
P ＜ 0.001), liver failure (1 case vs 10 cases; P = 0.003) and infection (1 case vs 10 cases;
P = 0.003). Multivariate Logistic regression analysis showed that infection was an independent
risk factor of cure time for patients with AFLP (OR = 23.692, 95%CI: 1.550～362.662, P =
0.023). Conclusions Infection is an independent risk factor affecting the cure time of patients
with AFLP. During the treatment of AFLP, effective prevention of infection is the key to rapid
recovery and shortening the course of disease.
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