妊娠妇女银屑病治疗的研究进展

Treatment of psoriasis in pregnant women

妊娠妇女银屑病的治疗与普通人群银屑病的治疗不同，不仅要考虑治疗方法的有效性，还应尽量避免对孕妇及胎儿产生的不良影响。目前，关于妊娠妇女银屑病的治疗主要有局部疗法、光疗法和系统疗法，尚无统一规范。首选局部疗法，外用糖皮质激素类药物被认为是一线疗法；光疗法中最常用的是中波紫外线；系统用药如维A酸类药物、糖皮质激素、免疫抑制剂及生物制剂，但可能对妊娠妇女自身产生不良影响，也可能导致胎儿宫内发育迟缓、畸胎、低出生体重儿等不良反应，因此，妊娠妇女的银屑病应慎用系统疗法。

The treatment of psoriasis in pregnancy is different fi＇om that of conventional psoriasis. Both efficacy and negative effects on patients and their fetuses should be taken into considerations for the treatment of pregnant women with psoriasis, which mainly includes topical therapy, phototherapy and systemic therapy at present. Topical therapy is the preferred choice, and topical corticosteroids are considered as the first-line treatment. Narrow band-ultraviolet B （NB-UVB） is the most commonly used light source for the phototherapy of psoriasis in pregnancy. Systemic treatments such as retinoids, corticosteroids, immunosuppressants and biologics, not only have a negative effect on pregnant women themselves, but also are associated with intrauterine growth retardation, teratogenesis and low birth weight newnates. Hence, systemic treatments should be used with caution in pregnant women with psoriasis.