妊娠合并系统性红斑狼疮妊娠结局的临床分析

Clinical Analysis of Pregnancy Complicated with Systemic Lupus Erythematosus

目的探讨妊娠合并系统性红斑狼疮(SLE)患者孕期病情及其对妊娠结局的影响。方法收集并回顾性分析2004年9月至2015年8月就诊于成都医学院第一附属医院的18例妊娠合并SLE患者的临床资料,根据SLE活动性的不同,将患者分为活动组(n=11)和非活动组(n=7)。结果活动组的妊娠丢失率、早产率、妊娠期合并症及并发症发生率较非活动组明显增高,差异有统计学意义(P<0.05)。妊娠期SLE病情活动以皮肤黏膜损害、狼疮性肾炎和抗磷脂综合症为主。结论妊娠合并SLE可增加不良母儿结局风险,建议SLE患者在医师指导下制定妊娠计划,孕前SLE稳定至少半年以上;同时,加强孕期随访,及早发现疾病活动并及时治疗。

Objective To investigate the clinical characteristics and pregnancy outcomes in pregnant women with systemic lupus erythematosus （SLE） .Methods The clinical data of 18 pregnant women with SLE treated in The First Affiliated Hospital of Chengdu Medical College between September of 2004 and August of 2015 were collected and analyzed retrospectively .The 18 cases were divided into the flare group with 11 cases and the non‐flare group with 7 cases according to the disease activity of SLE .Results The incidence of pregnancy loss ,premature birth and pregnancy complications was significantly higher in the flare group than in the non‐flare group （P〈0.05） . The most common symptoms of SLE in the pregnancy in the flare group were skin rash ,lupus nephritis ,and antiphospholipid syndrome .Conclusion The pregnancy complicated with SLE can result in more risks of poor maternal and neonatal outcomes .Therefore ,it is suggested that the patients with SLE should make a detailed plan of pregnancy and make the SLE conditions stable for at least half a year before conception under the guidance of obstetricians .Meanwhile ,the clinical indexes should be monitored closely during pregnancy .