Kang Suya, Zhou Liping, Wang Xiaoyan, Li Yongmei, Wang Yun
Department of Obstetrics, Suzhou Affiliated Hospital of Nanjing Medical University, Suzhou Municipal Hospital, China.
J Int Med Res. 2019 Feb;47(2):738-747. doi: 10.1177/0300060518809783. Epub 2018 Nov 19.
To investigate the effectiveness of high-dose glucocorticoids on hemolysis, elevating liver enzymes, and reducing platelets (HELLP) syndrome.
A total of 151 patients with HELLP syndrome were analyzed and divided into two groups. Six subgroups of treatment and control groups were divided into three grades in accordance with the American Mississippi Diagnostic Criteria.
There were no differences in general characteristics of the patients, primipara rate, minimum platelet recovery time, postpartum hemorrhage volume, postpartum hemorrhage rate, cumulative average of maternal damage, intensive care unit admission rate, perinatal mortality rate, and overall incidence rate of adverse outcomes in fetuses among the groups. The primipara rate in the control group of the third grade was significantly higher than that in the treatment group of the third grade. The treatment group of the second grade (88.7%) had a significantly higher preterm delivery rate than that in the control group of the second grade (66.7%). There were no differences in minimum hemoglobin, and maximum lactate dehydrogenase, alanine aminotransferase, and aspartate aminotransferase levels among the groups and subgroups.
High-dose glucocorticoids cannot significantly improve maternal and fetal prognoses and laboratory indices. However, our results might offer some clinical evidence for HELLP syndrome therapy.
探讨大剂量糖皮质激素对溶血、肝酶升高及血小板减少（HELLP）综合征的疗效。
对151例HELLP综合征患者进行分析并分为两组。治疗组和对照组的六个亚组根据美国密西西比诊断标准分为三个等级。
各组患者的一般特征、初产妇比例、血小板最低恢复时间、产后出血量、产后出血率、孕产妇损伤累积平均值、重症监护病房入住率、围产儿死亡率及胎儿不良结局总发生率无差异。三级对照组的初产妇比例显著高于三级治疗组。二级治疗组（88.7%）的早产率显著高于二级对照组（66.7%）。各组及亚组间最低血红蛋白、最高乳酸脱氢酶、丙氨酸氨基转移酶和天冬氨酸氨基转移酶水平无差异。
大剂量糖皮质激素不能显著改善母婴预后及实验室指标。然而，我们的结果可能为HELLP综合征的治疗提供一些临床证据。
