妊娠合并系统性红斑狼疮180例临床分析

A clinical analysis of 180 cases of systemic lupus erythematosus in pregnancy

目的:探讨孕期新发狼疮、狼疮肾炎对妊娠合并系统性红斑狼疮(SLE)患者母婴结局的影响。方法:回顾分析2009年1月至2018年12月广州医科大学附属第三医院收治的180例妊娠合并SLE患者的临床资料。依据SLE发生时间分为孕前SLE组和孕期新发SLE组;依据肾脏是否受累,将孕前SLE组分为狼疮肾炎组和非狼疮肾炎组。结果:相比活产产妇,胚胎丢失产妇的高血压、低补体血症、尿蛋白、贫血、狼疮肾炎发生率显著升高(P<0.05)。相比孕前SLE组,孕期新发SLE组的母婴结局更差。孕前SLE组中,相比非狼疮肾炎组,狼疮肾炎组的母体结局更差。结论:孕期新发SLE的母婴结局更差,孕前SLE狼疮肾炎组的母体结局更差。

Objective:To analyze the influence for both the mothers and babies of new-onset lupus during pregnancy and lupus nephritis to women with SLE in pregnancy.Method:We reviewed 180 cases of pregnant women with SLE from Jan.2009 to Dec.2018 at The Third Affiliated Hospital of Guangzhou Medical University.According to the occurred time of SLE,they were divided into pre-pregnancy SLE group and new SLE during pregnancy group.The pre-pregnancy SLE group were subdivided into lupus nephritis group and SLE group without renal-involvement.Results:Hypertension,hypocomplementemia,urine protein,anemia and lupus nephritis was significantly higher in cases of fetal loss pregnancies than that in cases of live birth pregnancies.Compared to women with pre-pregnancy SLE,women with new-onset SLE during pregnancy had worse fetal and maternal outcome.The lupus nephritis group had worse maternal outcome than the SLE group without renal-involvement.Conclusion:The new-onset lupus during pregnancy predict both harmful maternal and fetal outcome,a history of lupus nephritis harmful maternal outcome.