Early diagnosis is important to lower the mortality rate of acute fatty liver of pregnancy (AFLP). The Swansea criteria is commonly used to diagnose AFLP, but some terms could only be reached when symptoms and signs have progressed, or are not efficient in clinical practice. Therefore, it is necessary to select cost effective tests to simplify and facilitate early suspicion of acute fatty liver of pregnancy. This is a retrospective study of 28,800 medical records at the Second Xiangya Hospital from 2009 to 2015, including 41 patients with AFLP and 172 other diseases that could show similar symptoms to AFLP. The evaluated variables included past history of liver diseases, blood pressure, gastrointestinal symptoms, blood count, liver function test, coagulation function test and blood sugar test. The sensitivity, specificity, positive predict value and negative predict value were calculated for models in diagnosing AFLP. The significant variables associated with AFLP included gastrointestinal symptoms, blood pressure > 140/90 mmHg, aminotransferase> 42 IU/l, total bilirubin> 0.8 mg/dl, total bilirubin acid> 10.0 μmol/L, activated partial prothrombin time(APTT) > 34 s, prothrombin time(PT) > 14 s, white blood cells> 11 *106/l and blood sugar< 72 mg/dl. Gastrointestinal symptoms +aminotransferase +bilirubin +bile acid +APTT/PT showed 97.6% sensitivity and 97.1% specificity to diagnose AFLP. Adding blood pressure, blood sugar or white blood cells decreased the accuracy of the statistical model. Application of a statistical model including maternal symptoms, biochemical and haematological parameters has high diagnostic accuracy for earlier identification of AFLP. However, this finding needs to be tested in another cohort to determine whether this statistical model has the same performance.

中文翻译：

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妊娠急性脂肪肝的早期诊断测试：回顾性病例对照研究

早期诊断对于降低妊娠急性脂肪肝（AFLP）的死亡率很重要。斯旺西标准通常用于诊断AFLP，但是某些术语只有在症状和体征发展或在临床实践中无效时才能达成。因此，有必要选择具有成本效益的测试以简化和促进早期怀疑妊娠急性脂肪肝。这是一项对2009年至2015年在湘雅市第二医院进行的28,800例病历的回顾性研究，其中包括41例AFLP患者和172种其他可能表现出与AFLP类似症状的疾病。评估变量包括过去的肝脏疾病史，血压，胃肠道症状，血球计数，肝功能检查，凝血功能检查和血糖检查。敏感性，特异性，计算AFLP诊断模型的阳性预测值和阴性预测值。与AFLP相关的重要变量包括胃肠道症状，血压> 140/90 mmHg，氨基转移酶> 42 IU / l，总胆红素> 0.8 mg / dl，总胆红素酸> 10.0μmol/ L，活化的凝血酶原时间（APTT）> 34 s，凝血酶原时间（PT）> 14 s，白细胞> 11 * 106 / l，血糖<72 mg / dl。胃肠道症状+氨基转移酶+胆红素+胆汁酸+ APTT / PT对诊断AFLP的敏感性为97.6％，特异性为97.1％。增加血压，血糖或白细胞会降低统计模型的准确性。包括孕产妇症状在内的统计模型的应用，生化和血液学参数对AFLP的早期诊断具有较高的诊断准确性。但是，此发现需要在另一个队列中进行测试，以确定此统计模型是否具有相同的性能。