Minakami Hisanori, Yamada Hideto, Suzuki Shigenori
Department of Reproductive and Developmental Medicine, Hokkaido University Graduate School of Medicine, N15W7, Kita-ku, Sapporo 060-8638, Japan.
Semin Thromb Hemost. 2002 Dec;28(6):515-8. doi: 10.1055/s-2002-36693.
The syndrome of hemolysis, elevated liver enzymes, and low platelet count (HELLP syndrome) and of acute fatty liver of pregnancy (AFLP) do not have an abrupt onset. Thrombocytopenia or reduced antithrombin activity, or both, seen at presentation do not result from these complications. There are a small number of pregnant women who exhibit a gradual antenatal decline in platelet counts or antithrombin activity, or both, irrespective of the presence or absence of preeclampsia. Those who develop a profound decrease in either platelet counts or antithrombin activity are at an increased risk for developing perinatal aspartate aminotransferase (AST) elevation. Thrombocytopenia or reduced antithrombin activity, or both, precede the onset of these diseases. Therefore, monitoring of platelet counts and antithrombin activity during pregnancy is clinically useful for identifying women at an increased risk of the HELLP syndrome and AFLP. Because women with twin pregnancies are likely to exhibit a decrease in platelet counts or antithrombin activity, or both, compared with women with singleton pregnancies, HELLP syndrome and AFLP are more likely to occur in women with twin pregnancies.
溶血、肝酶升高和血小板计数降低综合征（HELLP综合征）以及妊娠急性脂肪肝（AFLP）并非突然起病。就诊时出现的血小板减少或抗凝血酶活性降低，或两者皆有，并非由这些并发症所致。有少数孕妇，无论有无子痫前期，孕期血小板计数或抗凝血酶活性，或两者均会逐渐下降。血小板计数或抗凝血酶活性显著降低的孕妇发生围产期天冬氨酸转氨酶（AST）升高的风险增加。血小板减少或抗凝血酶活性降低，或两者皆有，先于这些疾病的发病。因此，孕期监测血小板计数和抗凝血酶活性对识别发生HELLP综合征和AFLP风险增加的女性具有临床意义。与单胎妊娠女性相比，双胎妊娠女性更有可能出现血小板计数或抗凝血酶活性降低，或两者皆有，因此双胎妊娠女性发生HELLP综合征和AFLP的可能性更大。
