妊娠合并系统性红斑狼疮21例临床分析

Clinical analysis of 21 cases of pregnancy complicated with systemic lupus erythematosus

目的分析并总结妊娠合并系统性红斑狼疮(SLE)患者的临床特征及妊娠结局。方法回顾性分析2010年1月至2017年6月海军军医大学(第二军医大学)长海医院妇产科收治的21例妊娠合并SLE患者的临床资料,对其临床特点和妊娠结局进行总结分析。结果 21例患者中,2例于妊娠期发病,孕前诊断为SLE的19例患者中有9例妊娠期病情恶化、转为活动期。21例患者中,孕期定期产前检查13例(61.90%),正常分娩17例(80.95%),引产4例(19.05%);子痫前期6例(28.57%),早产6例(28.57%),胎儿宫内生长受限5例(23.81%),胎儿宫内窘迫6例(28.57%)。结论 SLE患者妊娠存在相当的风险性,妊娠可诱发SLE或加重病情,并可能出现严重的母儿并发症。SLE患者应在病情控制平稳后妊娠,并在产科和风湿科医师的共同监测下度过妊娠期和产褥期。

Objective To analyze and summarize the clinical characteristics and pregnancy outcomes of systemic lupus erythematosus（SLE） patients with pregnancy. Methods We retrospectively analyzed the clinical characteristics and pregnancy outcomes of 21 pregnant SLE patients in the Department of Obstetrics and Gynecology of Changhai Hospital of Navy Medical University（Second Military Medical University） from Jan. 2010 to Jun. 2017. Results Of 21 patients, 2 were diagnosed during pregnancy, and 9 out of 19 patients diagnosed before pregnancy were deteriorated and changed to active phase. Among the 21 patients, 13 cases（61.90%） received regular pregnancy examination, 17 cases（80.95%） gave birth, and 4 cases（19.05%） had induced labour. There were 6 cases（28.57%） having preeclampsia, 6 cases（28.57%） having premature birth, 5 cases（23.81%） having fetal intrauterine growth restriction, and 6 cases（28.57%） having fetal distress in uterus. Conclusion SLE patients have considerable risk of pregnancy, and pregnancy can induce SLE or aggravate the condition. SLE may cause serious maternal complications. Only at a stable condition can SLE patients start a pregnancy, and finish their pregnancy and puerperium under the joint monitoring of obstetricians and rheumatologists.