在初级硬化胆管炎的怀孕期间,母亲的肝脏相关症状
Jeremy S Nayagam1,2, Tobias J Weismüller3,4, Piotr Milkiewicz5,6
1Institute of Liver Studies, King's College Hospital, London, UK.
JHEP reports : innovation in hepatology
|December 13, 2023
概括
在初级硬化性胆道炎 (PSC) 患者怀孕期间恶化的肝脏症状与较差的无移植生存率有关. 怀孕可能会显示出临床前的PSC,强调需要仔细监测.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 胃肠病学 胃肠病学
- 产科和妇科 产科和妇科
背景情况:
- 怀孕期间初级硬化性胆道炎 (PSC) 管理缺乏明确的指导方针.
- 怀孕期间PSC患者肝脏症状恶化的情况已知但不太了解.
- 关于PSC患者的孕前风险和怀孕监测的数据有限.
研究的目的:
- 描述孕妇在PSC诊断之前和之后怀孕时的肝脏相关症状.
- 探索与孕妇PSC患者症状恶化和与肝脏有关的不良结果相关的因素.
- 为改善孕前咨询和PSC的妊娠管理提供数据.
主要方法:
- 对患有PSC的女性和活产的多中心回顾性观察性研究.
- 国际PSC研究小组数据来自12个欧洲中心.
- 包括450名患者,分析临床变量,怀孕症状 (,胆管炎) 和肝脏生物化学.
主要成果:
- 在已知PSC患者中,28.9%的怀孕报告了恶化的肝脏症状,与减少的无移植存活率相关 (HR3.02,p=0.02).
- 12.6%的患者在怀孕期间PSC诊断之前表现出异常的生物化学或症状.
- 怀孕期间症状恶化可能表明更先进的肝病或严重的PSC表型.
结论:
- 与肝脏相关的症状在PSC诊断之前的怀孕中很常见,可能会揭露早期疾病.
- 大约三分之一的孕妇PSC患者经历症状恶化,与预后较差相关.
- 这些发现支持加强对计划怀孕的PSC患者的监测和咨询.
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