【分　 类】 医药卫生
【关 键 词】 脂肪肝，急性，妊娠期   发病机制   临床表现  诊断  治疗
【来 　源】 互联网
【收　 录】 中文学术期刊网

正文：
【摘要】 妊娠期急性脂肪肝（Acute fatty liver of pregnancy, AFLP）是一种少见而严重的具有潜在致命危险的妊娠期并发症。其典型的表现是妊娠末三月和产后初期突发黄疸、凝血障碍、肝性脑病以及肝脏微泡性脂肪浸润，重则导致多器官功能衰竭直至死亡。发病机制尚未完全清楚，主要与患者的某些脂肪酸氧化酶缺陷有关。诊断需要与妊娠晚期合并病毒性肝炎、HELLP(Haemolysis, elevated liver enzymes, low platelets, HELLP)综合征、妊娠期肝内胆汁淤积症等鉴别。治疗关键是密切监护病情变化，立即终止妊娠，最大限度的支持疗法，预见性地预防和及时对症处理各种并发症；肝移植仍存在争议，因根据个体进行选择。
【关键词】 脂肪肝，急性，妊娠期   发病机制   临床表现  诊断  治疗
Progress in acute fatty liver of pregnancy  Xu Zhi-hua*, Ye Wei-jiang. *Department of Infectious Diseases, The First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou 310053, China      
Corresponding Author: Ye Wei-jiang, Department of Infectious Diseases, Zhejiang Province Hospital of Traditional Chinese Medicine, 310006, E-mail: ywjhzsh@hz.cn
【Abstract】Acute fatty liver of pregnancy is a rare but serious and potentially
fatal complication of pregnancy. Its typical performance is outburst jaundice,  coagulopathy, hepatic encephalopathy and microvesicular fatty infiltration of the liver,  even lead to multiple organ failure and death, during the last three months of pregnancy and early postnatal pregnancy. Pathogenesis is not entirely clear, defects in fatty acid oxidation secondary to various enzymatic deficiencies have been associated with acute fatty liver of pregnancy. Diagnosis requires  identification with these diseases: viral hepatitis during late pregnancy, haemolysis-elevated liver enzymes-low platelets syndrome, Intrahepatic cholestasis of pregnancy. The key treatment is closely monitoring changes in condition,immediate termination of pregnancy, the maximum supportive therapy, prevention of predictability and timely symptomatic treatment to various complication. Liver transplantation remains controversial and must be considered individually.