Martin J N, Blake P G, Perry K G, McCaul J F, Hess L W, Martin R W
Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson 39216-4505.
Am J Obstet Gynecol. 1991 Jun;164(6 Pt 1):1500-9; discussion 1509-13. doi: 10.1016/0002-9378(91)91429-z.
Despite much recent interest in HELLP syndrome (hemolysis, elevated liver enzymes, and low platelet count), there is little published information about the natural history of this unique form of severe preeclampsia-eclampsia. The time course and pattern of laboratory abnormalities for 158 patients with HELLP syndrome managed in a single tertiary referral center between 1980 and 1989 were studied retrospectively. Despite considerable patient variation, most gravid women with HELLP syndrome had decreasing platelet counts until 24 to 48 hours after delivery. Conversely, lactate dehydrogenase concentrations usually peaked 24 to 48 hours post partum. In all patients who recovered, a platelet count greater than 1,000,000/mm3 was spontaneously achieved by the sixth postpartum day or within 72 hours of platelet nadir. An upward trend in platelet count and a downward trend in lactate dehydrogenase concentrations should be apparent in patients without complications by the fourth postpartum day. These data provide baseline information against which the course of individual patients can be compared and the infrequent, atypical case identified for interventive therapy.
尽管近期对HELLP综合征（溶血、肝酶升高和血小板计数降低）颇为关注，但关于这种特殊形式的重度子痫前期-子痫自然病史的公开信息却很少。我们对1980年至1989年间在一家三级转诊中心接受治疗的158例HELLP综合征患者实验室异常的时间进程和模式进行了回顾性研究。尽管患者个体差异很大，但大多数患有HELLP综合征的孕妇在分娩后24至48小时内血小板计数持续下降。相反，乳酸脱氢酶浓度通常在产后24至48小时达到峰值。在所有康复的患者中，产后第六天或血小板计数最低点后72小时内血小板计数会自发升至大于1,000,000/mm³。无并发症的患者在产后第四天血小板计数应呈上升趋势，乳酸脱氢酶浓度应呈下降趋势。这些数据提供了基线信息，可据此比较个体患者的病程，并识别出罕见的非典型病例以便进行干预治疗。
