系统性红斑狼疮合并妊娠继发重度血小板减少的危险因素分析

Risk factors of severe thrombocytopenia secondary to pregnancy in systemic lupus erythematosus

目的探讨系统性红斑狼疮(systemic lupus erythematosus,SLE)合并妊娠继发重度血小板减少(sever thrombocytopenia,STP)的危险因素。方法回顾性分析广西医科大学第七附属医院(梧州市工人医院)2014年1月至2019年12月收治的47例SLE合并妊娠患者的临床资料,应用多因素Logistic回归分析SLE合并妊娠继发STP的危险因素。结果入组的患者中有11例继发STP,其中两组患者在骨髓巨核细胞减少以及血清催乳素(prolactin,PRL)水平差异上有统计学意义(P<0.05),经多因素Logistic回归分析显示,骨髓巨核细胞减少(OR:9.600,95%CI:2.358-39.089)和PRL≥184.46 g/L(OR:5.200,95%CI:1.322-7.940)是SLE合并妊娠继发STP的独立危险因素。结论骨髓巨核细胞减少与血清PRL≥184.46 g/L为SLE合并妊娠患者继发STP的独立危险因素,对于这类患者临床上应给予重视,对于防治不良妊娠结局具有重要意义。

Objective To explore the risk factors of systemic lupus erythematosus(SLE)complicated with severe thrombocytopenia(STP)secondary to pregnancy.Methods The clinical data of 47 patients with SLE combined pregnancy who were admitted to The Seventh Affiliated Hospital of Guangxi Medical University(Wuzhou Workers Hospital)from January 2014 to December 2019 were retrospectively analyzed.The risk factors of SLE combined with secondary STP were analyzed by multivariate logistic regression.Results 11 patients with secondary STP were included in the group.Among them,there were statistically significant differences in megakaryocyte reduction and serum prolactin(PRL)levels between the two groups(P<0.05).Multivariate Logistic regression analysis showed that the reduction of bone marrow megakaryocytes(OR:9.600,95%CI:2.358-39.089)and PRL≥184.46 g/L(OR:5.200,95%CI:1.322-7.940)were independent risk factors of SLE with pregnancy-induced STP.Conclusion Bone marrow megakaryocyte reduction and serum PRL≥184.46 g/L are independent risk factors for secondary STP in patients with SLE and pregnancy,which should be paid attention to clinically in these patients since they have important significance for preventing and treating adverse pregnancy outcomes.