体外受精—胚胎移植后妊娠合并急性粟粒性肺结核5例临床分析

Clinical analysis of acute miliary tuberculosis in five pregnant women with in vitro fertilization and embryo transfer

目的总结体外受精一胚胎移植(IVF-ET)后妊娠发生粟粒性肺结核的临床特点。方法回顾性分析2004年1月—2011年12月收治的5例IVF-ET后妊娠并发粟粒性肺结核患者临床资料。结果 IVF-ET后妊娠并发粟粒性肺结核临床表现以发热、呼吸困难等为主。实验室检查示白细胞升高,ESR、CRP升高,胸部影像学表现以粟粒性结节和浸润为主。2例人工终止妊娠,3例在2～4周内发生自然流产。经抗结核治疗5例患者均痊愈。结论发热为急性粟粒性肺结核的主要临床表现,IVF-ET后出现发热经抗炎治疗无效,需要警惕肺结核。

Objective To summarize the clinical characteristics of acute miliary tuberculosis in women with in vitro fertilization and embryo transfer （IVF-ET）. Methods Five cases of haematogenous disseminated tuberculosis after in vitro fertilization pregnancy from January 2004 to December 2011 were retrospectively analyzed. Results The clinical manifestation of pulmonary miliary tuberculosis were nonspecific. All cases presented with fever or dyspnea for several weeks. Chest image medicine showed typical military and infiltrate lesions. Artificial termination of pregnancy in 2 patients. Miscarriage occurred in 3 patients. 5 cases were cured after treatment. Conclusion The main symptom of miliary tuberculosis in pregnant women after IVF-ET was fever. Physician should be alerted to the occurrence of miliary tuberculosis in pregnant with long term fever.