Department of Obstetrics and Gynaecology, University of Torino, Torino, Italy.
Adv Clin Chem. 2011;53:85-104. doi: 10.1016/b978-0-12-385855-9.00004-7.
The HELLP syndrome is a serious complication of pregnancy characterized by hemolysis (H), elevated liver (EL) enzymes, and low platelet (LP) count that occurs in 0.2-0.6% of all pregnancies and in 10-20% of cases with severe preeclampsia and frequently leads to adverse maternal and perinatal outcome. The exact pathobiology of HELLP syndrome has not been clearly defined. As it is considered a form or a complication of severe preeclampsia, it likely has its origin in aberrant placental development and function resulting in ischemia-producing oxidative stress. However, there is still a debate on whether HELLP must be considered a severe form of preeclampsia or a separate disease entity. It can be described as a placenta-induced disease, as is preeclampsia itself, but with a more acute and predominant inflammatory process typically targeting the liver and with a greater activation of the coagulation system. This occurs during a disordered immunologic process and may be due to a genetic predisposition. In this review, we discuss the main biochemical characteristics of HELLP syndrome, particularly focusing on molecular aspects of placental involvement and maternal systemic responses.
HELLP 综合征是妊娠的严重并发症，其特征为溶血（hemolysis，H）、肝酶升高（elevated liver enzymes，EL）和血小板减少（low platelet count，LP），在所有妊娠中的发生率为 0.2%至 0.6%，在严重子痫前期中的发生率为 10%至 20%，常导致母婴不良预后。HELLP 综合征的确切病理生物学尚未明确界定。由于它被认为是严重子痫前期的一种形式或并发症，因此其起源可能是胎盘发育和功能异常，导致产生缺血性氧化应激。然而，关于 HELLP 是否应被视为严重子痫前期的一种形式或独立的疾病实体仍存在争议。它可以被描述为一种胎盘引起的疾病，就像子痫前期本身一样，但具有更急性和更主要的炎症过程，通常针对肝脏，并具有更大的凝血系统激活。这发生在紊乱的免疫过程中，可能与遗传易感性有关。在这篇综述中，我们讨论了 HELLP 综合征的主要生化特征，特别是重点关注胎盘参与和母体全身反应的分子方面。
