Curtin W M, Weinstein L
Department of Obstetrics and Gynecology, Medical College of Ohio, Toledo 43614-5809, USA.
J Perinatol. 1999 Mar;19(2):138-43. doi: 10.1038/sj.jp.7200165.
HELLP (hemolysis, elevated liver enzymes, and low platelets) syndrome is a variant of severe preeclampsia which is associated with substantial maternal and perinatal morbidity and mortality. As with preeclampsia, the etiology and pathogenesis of HELLP syndrome is not completely understood. An increase in vascular thrombosis and activation of the coagulation system may be important in the clinical presentation of this disorder. Laboratory criteria for the diagnosis of HELLP syndrome have been classically described but lack uniformity among different institutions. Aggressive management of HELLP syndrome with expeditious delivery appears to yield the lowest perinatal mortality rates. Conservative or expectant management has been associated with higher stillbirth rates with antenatal corticosteroids not causing resolution of the laboratory abnormalities. Resolution of laboratory abnormalities in HELLP syndrome runs a protracted course over several days after delivery. Despite nearly two decades since HELLP syndrome has been defined as a clinical entity, treatment for the disorder still remains delivery of the patient.
HELLP（溶血、肝酶升高和血小板减少）综合征是重度子痫前期的一种变体，与孕产妇和围产儿的高发病率及死亡率相关。与子痫前期一样，HELLP综合征的病因和发病机制尚未完全明确。血管血栓形成增加和凝血系统激活可能在该疾病的临床表现中起重要作用。HELLP综合征的实验室诊断标准虽已被经典描述，但不同机构之间缺乏一致性。积极处理HELLP综合征并迅速分娩似乎能使围产儿死亡率降至最低。保守或期待治疗与较高的死产率相关，产前使用糖皮质激素并不能使实验室异常情况得到缓解。HELLP综合征实验室异常情况的缓解在分娩后的数天内呈迁延过程。尽管HELLP综合征被定义为一种临床实体已近二十年，但该疾病的治疗仍然是让患者分娩。
