产后血栓性微血管病综合征
Postpartum thrombotic microangiopathic syndrome.
作者信息
Owens Michelle Y, Martin James N, Wallace Kedra, Keiser Sharon D, Parrish Marc R, Tam Tam Kiran B, Martin Rick W
机构信息
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Winfred L. Wiser Hospital for Women and Infants, University of Mississippi Medical Center, 2500 N. State St., Jackson, MS 39216, United States.
出版信息
Transfus Apher Sci. 2013 Feb;48(1):51-7. doi: 10.1016/j.transci.2012.05.016. Epub 2012 Jun 14.
OBJECTIVE
Characterization of syndromes for patients with life-threatening, progressively worsening hemolysis-elevated-liver-enzymes-and-platelet (HELLP) syndrome-like diseases and with thrombotic microangiopathies. RETROSPECTIVE STUDY DESIGN: Patients who underwent postpartum plasma-exchange (PPEX) for preeclampsia-related, and microangiopathy/coagulopathy illnesses unresponsive to medical therapy between 1994 and 2008 in our center and elsewhere.
RESULTS
Nine patients were treated with PPEX in our center with 78% maternal survival. Treatment with PPEX increased platelet levels (p=0.048), decreased serum lactic dehydrogenase (p=0.0012) and aspartate aminotransferase (p=0.0001).
CONCLUSION
Nineteen patients from publications combined with our patients suggest five categories of postpartum thrombotic microangiopathy syndrome that exhibit HELLP syndrome criteria and respond to PPEX.
目的
对患有危及生命、进行性加重的溶血-肝酶升高-血小板减少（HELLP）综合征样疾病及血栓性微血管病的患者的综合征进行特征描述。回顾性研究设计：1994年至2008年期间在我们中心及其他地方因先兆子痫相关疾病、对药物治疗无反应的微血管病/凝血病而接受产后血浆置换（PPEX）的患者。
结果
我们中心有9名患者接受了PPEX治疗，产妇生存率为78%。PPEX治疗使血小板水平升高（p = 0.048），血清乳酸脱氢酶降低（p = 0.0012），天冬氨酸转氨酶降低（p = 0.0001）。
结论
来自出版物的19名患者与我们的患者相结合，提示有五类产后血栓性微血管病综合征符合HELLP综合征标准并对PPEX有反应。
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