溶血、肝酶升高、血小板减少综合征和孤立性子痫前期的不同危险因素和结果
Divergent Risk Factors and Outcomes in Hemolysis, Elevated Liver Enzymes, and Low Platelets Syndrome and Isolated Preeclampsia.
摘要(中文译文)
溶血、肝酶升高和低血小板（HELLP）综合征通常与子痫前期（PE）相关。伴有HELLP的子痫前期（PE-HELLP）或孤立性子痫前期（iPE）女性的危险因素及短期和长期结局尚不清楚。利用妊娠心血管疾病队列（CONCEPTION）（一项法国全国性、基于人群的前瞻性队列）研究的数据，纳入2010年至2018年间所有在妊娠≥22周分娩的女性。主要结局为死亡、心血管、脑血管、血栓栓塞事件及肾功能衰竭（RF）。在2，829，700名初产妇中，研究了73，736名iPE女性、9147名PE-HELLP女性和2，746，817名对照女性。糖尿病、慢性高血压和肥胖与iPE的关联比与PE-HELLP的关联更频繁。社会剥夺与iPE呈正相关，但与PE-HELLP呈负相关。慢性炎症性疾病和狼疮与PE-HELLP的关联比与iPE的关联更强。在第一年内，与对照组相比，iPE和PE-HELLP是高血压及所有其他主要不良事件的重大危险因素；然而，PE-HELLP发生主要不良心血管事件（MACEs）、卒中、血栓栓塞和RF的风险显著高于iPE。第一年之后，iPE仍与所有结局显著相关，而PE-HELLP与对照组相比仅为高血压和RF的危险因素；iPE和PE-HELLP的RF风险相似。iPE与伴HELLP的PE在危险因素及主要并发症的类型和动态变化方面存在差异。
Abstract
The hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome usually occurs in association with preeclampsia (PE). Risk factors and short-term and long-term outcomes of women with PE with HELLP (PE-HELLP) or isolated PE (iPE) are unclear. Using data from the Cohort of Cardiovascular Diseases in Pregnancy (CONCEPTION) (a French nationwide, population-based, prospective cohort) study, all women who gave birth at ≥22 weeks of gestation between 2010 and 2018 were included. The main outcomes were mortality, cardiovascular, cerebrovascular, thromboembolic events, and renal failure (RF). Among the 2,829,700 women with first deliveries, 73,736 women with iPE, 9147 women with PE-HELLP and 2,746,817 women controls were studied. Diabetes, chronic hypertension, and obesity were more frequently associated with iPE than PE-HELLP. Social deprivation was positively associated with iPE but negatively associated with PE-HELLP. Chronic inflammatory diseases and lupus were more associated with PE-HELLP than iPE. During the first year, iPE and PE-HELLP constituted major risk factors for hypertension and all other major adverse events versus controls; however, PE-HELLP was a significantly stronger risk of major adverse cardiovascular events (MACEs), stroke, thromboembolism, and RF than iPE. After the first year, iPE remained significantly associated with all outcomes, whereas PE-HELLP was a risk factor only for hypertension and RF versus controls; the risk of RF was similar for iPE and PE-HELLP. iPE and PE with HELLP differ regarding their risk factors and types and dynamics of their major complications.
如何引用
AMA
Jean-Michel Halimi, Grégory Lailler, Valentin Maisons, Bénédicte Sautenet, Laurent Fauchier, Jean-Baptiste de Fréminville, et al. Divergent Risk Factors and Outcomes in Hemolysis, Elevated Liver Enzymes, and Low Platelets Syndrome and Isolated Preeclampsia.. Kidney international reports. 2026; doi:10.1016/j.ekir.2026.106681.
APA
Jean-Michel Halimi, Grégory Lailler, Valentin Maisons, Bénédicte Sautenet, Laurent Fauchier, Jean-Baptiste de Fréminville, et al (2026). Divergent Risk Factors and Outcomes in Hemolysis, Elevated Liver Enzymes, and Low Platelets Syndrome and Isolated Preeclampsia.. Kidney international reports. https://doi.org/10.1016/j.ekir.2026.106681
GB/T 7714
Jean-Michel Halimi, Grégory Lailler, Valentin Maisons, Bénédicte Sautenet, Laurent Fauchier, Jean-Baptiste de Fréminville, et al. Divergent Risk Factors and Outcomes in Hemolysis, Elevated Liver Enzymes, and Low Platelets Syndrome and Isolated Preeclampsia.[J]. Kidney international reports, 2026 doi:10.1016/j.ekir.2026.106681.
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