Predicting women at high risk of developing the HELLP syndrome

预测罹患 HELLP 综合征的高风险女性

• 批准号: 10671568
• 负责人: MINAKAMI Hisanori
• 金额: $ 1.47万
• 依托单位: Jichi Medical School
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 1998
• 资助国家: 日本
• 起止时间: 1998 至 2000
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-10671568/
• 关键词: twin; HELLP syndrome; thrombocytopenia; liver dysfunction; antithrombin; Pregrancy; fatly liver; disseminated intravascular loagulation

We studied prospectively 637 women with singleton pregnancies and 237 women with twin pregnancies to define the clinical features of gestational thrombocytopenia and pregnancy-induced antithrombin III deficiency. Our hypothesis is that women with gestational thrombocytopenia and/or pregnancy-induced antithrombin III deficiency are likely to develop liver dysfunction peripartum. Following results were obtained. Women who exhibited an antenatal gradual declines in platelet count and/or antithrombin III activity were likely to show an elevated perinatal serum level of aspartate aminotransferase. Women with twin pregnancies were more likely to exhibit a gradual declines in platelet count and antithrombin III activity than did women with singleton pregnancies. Serum level of thrombin-antithrombin complex (TAT) was significantly lower in twin than in singleton pregnancies. Antithrombin III activity significantly correlated inversely with serum level of TAT, suggesting that a reduced antithrombin III activity resulted from an enhanced thrombin generation. These results suggest that (1) monitoring of platelet count/antithrombin III activity identifies women at high risk of developing the HELLP syndrome, (2) women with twin pregnancies are more likely to develop the HELLP syndrome than were women with singleton pregnancies, and (3) thrombin generation is increased in twin pregnancies compared with singleton pregnancies.

我们前瞻性地研究了637名单胎妊娠妇女和237名双胎妊娠妇女，以确定妊娠期血小板减少症和妊娠诱导的抗凝血酶III缺乏症的临床特征。我们的假设是，妊娠期血小板减少和/或妊娠引起的抗凝血酶III缺乏症的妇女可能会在围产期发生肝功能障碍。获得了以下结果。产前出现血小板计数和/或抗凝血酶III活性逐渐下降的妇女，围产期血清天冬氨酸氨基转移酶水平可能升高。与单胎妊娠的妇女相比，双胞胎怀孕的妇女更有可能表现出血小板计数和抗凝血酶III活性的逐渐下降。双胎孕妇血清凝血酶-抗凝血酶复合体(TAT)水平明显低于单胎孕妇。抗凝血酶III活性与血清TAT水平显著负相关，提示抗凝血酶III活性降低是由于凝血酶生成增加所致。这些结果表明：(1)监测血小板计数/抗凝血酶III活性可确定患HELLP综合征的高危妇女，(2)双胎妊娠的妇女比单胎妊娠的妇女更有可能患HELLP综合征，(3)与单胎妊娠相比，双胎妊娠的凝血酶生成增加。

项目成果

Minakami H: "Relation between gestational thrombocytopenia and the HELLP syndrome."Gynecol Obstet Invest. 46. 41-45 (1998)

Minakami H：“妊娠期血小板减少症与 HELLP 综合征之间的关系。”Gynecol Obstet Invest。

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Itoi H: "Comparison of the long-term effects of oral estriol with the effects of conjugated estrogen on serum lipid profile in early menpausal women."Maturitas. 36. 217-222 (2000)

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