HELLP综合征实验室特点分析

Analysis of laboratory characteristics of HELLP syndrome

目的研究HELLP综合征患者分娩前后实验室指标变化特点。方法选取2008年12月至2018年11月北京大学第三医院产科住院治疗的127例HELLP综合征患者的资料进行回顾性分析。采集患者空腹血液,常规动态监测血常规、肝功能及肾功能及相关指标同时给予规范治疗,对相关指标进行统计学分析。结果HELLP综合征患者占本院同期分娩产妇的0.4%,其中完全性HELLP综合征74例,部分性HELLP综合征53例;产前HELLP综合征94例,产后HELLP综合征33例;完全性HELLP组患者血小板计数均明显低于部分性HELLP组(P<0.05);完全性HELLP组患者的血总胆红素(TBIL)、天冬氨酸转氨酶(AST)及乳酸脱氢酶(LDH)则显著高于部分性HELLP组(P<0.05);两组间血清肌酐(Cr)水平有极显著差异(P<0.01)。94例产前HELLP综合征患者中,92例患者的血小板和肝功能均于产后24 h开始恢复,并在产后5 d恢复正常;33例产后HELLP综合征患者除1例死亡,其余均于产后24~48 h实验室指标降至最低,后逐渐恢复出院。结论HELLP综合征患者大部分于产后5 d化验室指标恢复至孕前水平。

Objective To study the changes of laboratory indexes of HELLP syndrome before and after delivery.Methods Information on 127 patients with HELLP syndrome who diagnosed and hospitalized in Peking University Third Hospital from December 2008 to November 2018 were analyzed retrospectively.The fasting blood of the patients were collected and the routine blood test,liver and renal function were monitored dynamically.Results The patients with HELLP syndrome accounted for 0.4%of the total parturients in our hospital at the same period,including 74 cases of complete HELLP syndrome,53 cases of partial HELLP syndrome,94 cases of prenatal HELLP syndrome and 33 cases of postpartum HELLP syndrome.The platelet count in the complete HELLP group was significantly lower than that in the partial HELLP group(P<0.05),and the total bilirubin(TBIL)and aspartate transaminase(AST)in the complete HELLP group and lactate dehydrogenase(LDH)were significantly higher than partial HELLP group(P<0.05);there was a significant difference in serum creatinine(Cr)between the two groups(P<0.01).In 94 cases of prenatal HELLP syndrome,the platelet and liver function of 92 cases began to recover in 24 hours postnatal,and returned to normal in 5 days postnatal.Except for on dead case,32 out of the 33 postnatal HELLP syndrome decreased to the lowest laboratory index in 24-48 hours postnatal,and then gradually recovered.Conclusion Most of the patients with HELLP syndrome recovered to the prepregnancy level on the 5th day after delivery.