Oosterhof H, Voorhoeve P G, Aarnoudse J G
Department of Obstetrics and Gynaecology, University Hospital, Groningen, The Netherlands.
Am J Obstet Gynecol. 1994 Aug;171(2):526-30. doi: 10.1016/0002-9378(94)90293-3.
Our purpose was to test the hypothesis that the HELLP (hemolysis, elevated liver enzymes, and low platelets) syndrome is the result of excessive vasoconstriction of the hepatic arterial circulation.
Doppler ultrasonography was used to measure the pulsatility index of the common hepatic artery in 14 women with preeclampsia, 15 with preeclampsia complicated by HELLP syndrome, and 8 with HELLP syndrome but without proteinuria. Gestational age ranged from 24 to 38 weeks. The study group was compared with a reference group (n = 42).
Both in preeclampsia and in the HELLP syndrome the hepatic artery pulsatility index values were significantly increased compared with the reference group. However, no significant differences were found between the preeclamptic group, the HELLP group with proteinuria, and those with HELLP without proteinuria.
These findings indicate that hepatic artery resistance to blood flow is increased in preeclampsia in the presence or absence of the HELLP syndrome. The results also demonstrate that vasoconstriction of the hepatic arteries is not more pronounced in the HELLP syndrome than in other manifestations of preeclampsia. Therefore factors other than vasoconstriction are likely to be responsible for the development of the HELLP syndrome.
我们的目的是检验以下假设，即HELLP（溶血、肝酶升高和血小板减少）综合征是肝动脉循环过度血管收缩的结果。
采用多普勒超声测量14例先兆子痫妇女、15例合并HELLP综合征的先兆子痫妇女和8例无蛋白尿的HELLP综合征妇女肝总动脉的搏动指数。孕周为24至38周。将研究组与一个参照组（n = 42）进行比较。
与参照组相比，先兆子痫组和HELLP综合征组的肝动脉搏动指数值均显著升高。然而，先兆子痫组、有蛋白尿的HELLP组和无蛋白尿的HELLP组之间未发现显著差异。
这些发现表明，无论是否存在HELLP综合征，先兆子痫时肝动脉对血流的阻力均增加。结果还表明，HELLP综合征时肝动脉的血管收缩并不比先兆子痫的其他表现更明显。因此，血管收缩以外的因素可能是HELLP综合征发病的原因。
