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妊娠合并系统性红斑狼疮62例临床分析 被引量:1

Clinical analysis of 62 pregnant cases with systemic lupus erythematosus
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摘要 目的:探讨妊娠合并系统性红斑狼疮(SLE)育龄期女性的妊娠特点及对母婴结局的影响。方法:回顾性分析2010年1月至2019年4月在武汉大学中南医院的57名SLE患者共62例的妊娠情况(其中5例有2次妊娠),包括妊娠期间患者的特征、临床表现和实验室数据。患者分为两组,一组在妊娠期或产褥期初次被明确诊断为SLE(初发SLE组),另一组妊娠前患有SLE(既往SLE组)。既往SLE组进一步分为狼疮性肾炎组和肾脏未受累组。结果:①初发SLE组比既往SLE组的抗磷脂抗体综合征、疾病活动性、高血压、低补体血症、血小板减少和贫血等发生率高(P<0.05)。②初发SLE组比既往SLE组妊娠结局差(P<0.05)。③狼疮性肾炎孕产妇的妊娠结局差(P<0.05)。结论:SLE患者选择适当的妊娠时机,只有在SLE稳定期妊娠并在妊娠期间加强风湿免疫科及产科的监护下,可以提高活产率;降低妊娠期间病情活动,可获良好的妊娠结局。 Objective:To investigate the pregnancy characteristics and the effect of maternal and infant out-comes in pregnant women with systemic lupus erythematosus(SLE).Methods:A total of 62 pregnan-cies of 57 SLE patients from January 2010 to April 2019 in Zhongnan Hospital of Wuhan University were retrospectively investigated.The patients were divided into new-onset SLE group who were firstly diagnosed with SLE during pregnancy or puerperium,and pre-existing SLE group who had a history of SLE.The pre-existing SLE group was Sub-divided into lupus nephritis groups and non-renal involvement SLE group.Results:①Antiphospholipid antibody syndrome,disease activity,hypertension,hypomorphemia,thrombocytopenia,and anemia during pregnancy were more common in new-onset SLE group than in pre-existing SLE group(all P<0.05);②New lupus during pregnan-cy had poorer pregnancy outcomes(P<0.05);③The maternal outcome in the lupus nephritis group was worse than that in the non-renal involvement SLE group(P<0.05).Conclusion:SLE patients should choose an appropriate time for pregnancy.Good pregnancy outcome can be obtained when SLE is under control and pregnancy is under closely monitoring.
作者 李梦林 张蔚 郭娟娟 LI Menglin;ZHANG Wei;GUO Juanjuan(Dept.of Obstetrics and Gynecology,Zhongnan Hospital of Wuhan University,Wuhan 430071,Hubei,China)
出处 《武汉大学学报(医学版)》 CAS 2020年第5期811-814,共4页 Medical Journal of Wuhan University
关键词 系统性红斑狼疮 妊娠 狼疮性肾炎 结局 Systemic Lupus Erythematosus Pregnancy Lupus Nephritis Pregnancy Outcome
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