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Updated: Feb 26, 2026

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评估与代谢功能障碍相关的脂肪性肝病,相关的不良妊娠结果和产后孕产妇过程,利用在怀孕期间具有受控减弱参数的过渡性弹性体:一项前性队列研究

Marcia Lange¹, Jeanette Rios¹, Cecilia Katzenstein¹

¹(M Lange MD); (M Lange, C Katzenstein BA, T Worthington BSBA, N Rodriguez BA, K Sigel MD); (J Rios MD); (C Carroll MD); (R Meislin MD, Prof R Sperling MD); (P Argiriadi MD, S Rosberger MD); (E Rosenbluth MD, Prof N A Terrault MD); (T Kushner MD).

The Lancet. Obstetrics, gynaecology, & women's health

|February 25, 2026

概括

与代谢功能障碍相关的脂肪性肝病 (MASLD) 影响了11%的孕妇. 控制衰减参数 (CAP) 的振动控制过时弹性图 (VCTE) 可以评估MASLD的患病率,并与不良妊娠结果有关.

科学领域:

肝病学肝病学是一种肝病学.
产科产科产科产科产科
代谢疾病代谢疾病

背景情况:

在怀孕期间与代谢功能障碍相关的脂肪性肝病 (MASLD) 增加了三倍,需要更好的诊断工具,除了有限的超声波外.
目前的非怀孕指南使用振动控制的短暂弹性图 (VCTE) 与受控衰减参数 (CAP) 进行肝病评估.
关于VCTE的实用性和孕妇人口中MASLD的流行情况的数据有限.

研究的目的:

为了评估MASLD在孕妇中使用VCTE衍生的CAP的患病率.
评估VCTE衍生的CAP分数升高与不良妊娠结果之间的关联.
为了探索妊娠期间肝硬化和肝硬化的预测因素.

主要方法:

在247名孕妇身上进行了控制减弱参数 (CAP) 和肝硬度测量 (LSM) 的振动控制过时弹性图 (VCTE) 测量.
在怀孕期间 (24-32周) 和分娩后进行了评估.
多变量逻辑回归分析了肝脏肥胖症/硬度的预测因素以及与不良结果的关联.

主要成果:

MASLD的患病率为11% (95% CI 7-15%),由VCTE衍生的CAP和心脏代谢疾病证据确定.
妊娠前增加的BMI预测了更高的CAP分数,而多囊性卵巢综合征预测了肝硬度.
升高的CAP分数与怀孕的肝脏内胆固醇化相关,以及怀孕年龄大的婴儿的LSM.

结论:

由VCTE衍生的CAP评估发现了妊娠中MASLD的显著患病率,其他方法可能无法诊断.
在产科护理中,VCTE显示出作为诊断和监测肝病的非侵入性工具的前景.
需要进一步的研究来证实VCTE衍生的CAP在怀孕中的预后价值.

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