Haeger M, Unander M, Bengtsson A
Department of Obstetrics and Gynecology, Sahlgren Hospital, Göteborg, Sweden.
Obstet Gynecol. 1990 Oct;76(4):698-702.
Complement activation was studied in ten consecutive pregnant women developing hemolysis, elevated liver enzymes, and low platelet count (HELLP syndrome) and ten other women with normal pregnancies. Blood samples for anaphylatoxin (C3a/C3a desArg and C5a/C5a desArg) and terminal C5b-9 complement complex determinations were drawn at delivery and 24 hours and 7 days later. Women developing HELLP syndrome had higher plasma levels of anaphylatoxins with delivery than did women with uneventful pregnancies. The plasma levels of terminal C5b-9 complement complexes at the time of delivery were increased as compared with levels 1 and 7 days after delivery in women with HELLP syndrome. The plasma concentrations of the anaphylatoxins and the terminal C5b-9 complement complexes returned to normal levels within 1 week after delivery in the HELLP group. The formation of C5b-9 complement complex indicates that the terminal part of the complement cascade has been activated and that C5a has been formed and eliminated. Complement activation with release of anaphylatoxins and terminal C5b-9 complement complexes may be one etiologic factor behind the elevated blood pressure, hemolysis, liver insufficiency, and platelet consumption seen in these patients.
对10例连续发生溶血、肝酶升高和血小板计数降低（HELLP综合征）的孕妇以及10例其他正常妊娠的孕妇进行了补体激活研究。在分娩时、24小时后和7天后采集血样，用于测定过敏毒素（C3a/C3a去精氨酸和C5a/C5a去精氨酸）和末端C5b-9补体复合物。发生HELLP综合征的孕妇分娩时血浆过敏毒素水平高于妊娠过程顺利的孕妇。与HELLP综合征孕妇分娩后1天和7天的水平相比，分娩时末端C5b-9补体复合物的血浆水平升高。在HELLP组中，过敏毒素和末端C5b-9补体复合物的血浆浓度在分娩后1周内恢复到正常水平。C5b-9补体复合物的形成表明补体级联反应的末端部分已被激活，并且C5a已形成并被清除。过敏毒素和末端C5b-9补体复合物的释放所导致的补体激活可能是这些患者出现血压升高、溶血、肝功能不全和血小板消耗的一个病因。
