妊娠期血栓性血小板减少性紫癜和溶血性尿毒症综合征的识别与治疗

Identification and treatment of gestational thrombocytopenic purpura and hemolytic uremic syndrome

血栓性血小板减少性紫癜(TTP)与溶血性尿毒症综合征(HUS)均属于血栓性微血管病,起病急、病情重、病死率高。虽然不是妊娠期特有疾病,但是因临床稀发,并且与常见的妊娠期特有疾病(重度子痫前期、HELLP综合征)临床表现具有显著同质化,容易被漏诊误诊。文章就其临床表现、发病机制、诊断标准、鉴别诊断、治疗方案进行总结归纳,旨在为临床医生判断和救治提供借鉴。

Both thrombotic thrombocytopenic purpura(TTP)and hemolytic uremic syndrome(HUS)are classified as thrombotic microangiopathy(TMA),which has the characteristic of acute onset,severe illness and a high mortality.TMAs are relatively rare disease.They are not pregnancy-specific diseases;however,they are clinical rare,and have similar clinical manifestations with some common pregnancy-specific diseases(severe preeclampsia,HELLP syndrome),so they are most likely misdiagnosed or there may be missed diagnosis.This article summarizes the clinical manifestations,pathogenesis,diagnostic criteria,differential diagnosis,and therapy.It provides reference for clinicians’ judgment and treatment.