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产后地塞米松用于溶血、肝酶升高和血小板减少(HELLP)综合征女性:一项双盲、安慰剂对照、随机临床试验。

Postpartum dexamethasone for women with hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome: a double-blind, placebo-controlled, randomized clinical trial.

作者信息

Katz Leila, de Amorim Melania Maria Ramos, Figueiroa José Natal, Pinto e Silva João Luiz

机构信息

Department of Obstetrics, Professor Fernando Figueira Institute for Maternal and Child Health Care, Recife, Pernambuco, Brazil.

出版信息

Am J Obstet Gynecol. 2008 Mar;198(3):283.e1-8. doi: 10.1016/j.ajog.2007.10.797. Epub 2008 Jan 14.

Abstract

OBJECTIVE

The purpose of this study was to determine the effectiveness of postpartum dexamethasone in patients with hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome.

STUDY DESIGN

A prospective, randomized, double-blind trial was conducted in which 105 women with HELLP syndrome were enrolled and assigned randomly to treatment or placebo groups following delivery. Duration of hospital stay, maternal morbidity, and laboratory and clinical parameters were evaluated.

RESULTS

There was no difference in maternal morbidity or mortality between the 2 groups. There was also no difference in duration of hospitalization and the need for rescue scheme or the use of blood products between groups. Linear model adjustments showed no significant difference between groups with respect to the pattern of platelet count recovery, aspartate aminotransferase, lactate dehydrogenase, hemoglobin, or diuresis.

CONCLUSION

These findings do not support the use of dexamethasone in the puerperium for recovery of patients with HELLP syndrome.

摘要

目的

本研究旨在确定产后地塞米松对溶血、肝酶升高和血小板减少(HELLP)综合征患者的疗效。

研究设计

进行了一项前瞻性、随机、双盲试验,105例HELLP综合征妇女入组,分娩后随机分配至治疗组或安慰剂组。评估住院时间、孕产妇发病率以及实验室和临床参数。

结果

两组间孕产妇发病率和死亡率无差异。两组间住院时间、是否需要救援方案或使用血液制品也无差异。线性模型调整显示,两组在血小板计数恢复模式、天冬氨酸转氨酶、乳酸脱氢酶、血红蛋白或利尿方面无显著差异。

结论

这些发现不支持在产褥期使用地塞米松促进HELLP综合征患者恢复。

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