HELLP综合征的临床特点与结局分析

Clinical characteristics and outcomes of HELLP syndrome

目的探讨子痫合并溶血、肝酶升高、血小板计数减少(HELLP综合征)患者的临床特点及结局。方法子痫患者59例,依据有无合并HELLP综合征分为HELLP综合征组12例和无HELLP综合征组47例。分析两组患者的临床信息、生化指标、孕妇病死率。结果两组孕妇的年龄、发病孕周、规律产检,差异无统计学意义(P>0.05)。而HELLP组孕妇抽搐后收缩压较无HELLP组显著升高,差异有统计学意义(P<0.05)。HELLP组孕妇LDH、AST及Cr水平明显高于无HELLP组;而血小板明显低于无HELLP组,差异有统计学意义(均P<0.05)。HELLP组病死率(25%)显著高于无HELLP组,差异有统计学意义(P<0.05)。结论子痫合并HELLP综合征在临床中并非少见,严重威胁母婴安全。早明确诊断、适时终止妊娠及综合性治疗,可以降低母婴病死率。

Objective To investigate the clinical characteristics and outcomes of the obstetric patients with concurrent eclampsia and hemolysis,elevated liver enzymes,and low platelets syndrome（HELLP） syndrome.Methods Five-nine patients in the study were divided into two groups according to with or without HELLP syndrome.Clinical characteristics,biochemistry markersindexes and,death rate of maternamaternal mortality were analyzed.Results （1） Clinical data：The incidence of eclampsia with HELLP syndrome（12 cases） was 20.3%.There were no differences in age,gestational weeks and rate of regular prenatal care between two groups,respectively.For eclampsia without HELLP syndrome group,its systolic blood pressure was higher（P ＆lt;0.05）.（2） Laboratory profiles：Levels of lactic dehydrogenase（LDH）,aspartate transaminase（AST）,and creatinine（Cr）in eclampsia with HELLP syndrome group were significantly higher than those in eclampsia with at HELLP syndrome group,respectively.Level of platelet count in eclampsia with HELLP syndrome group was significant lower than that in eclampsia without HELLP syndrome group（P＆lt;0.05）.（3） Clinical outcomes：The maternal mortality in eclampsia with HELLP syndrome patients was 25%, which was significantly hisher higher than that in eclampsia without HELLP syndrome group,and there existed statistical significance（P＆lt;0.05）.Conclusion The incidence of eclampsia concurrent HELLP syndrome is not rare and the maternal mortality rate is significantly higher.The mortality of mothers and their infants can be reduced through timely diagnosis,pregnancy termination and comprehensive therapy.