系统性红斑狼疮孕妇的早产结局分析

目的探讨系统性红斑狼疮(SLE)合并妊娠患者的早产妊娠结局的临床特点。方法回顾性收集204例SLE合并妊娠患者的年龄、孕产次、服药情况及实验室检查指标等临床资料,根据妊娠结局分为早产分娩组(86例)和足月分娩组(118例),比较两组的临床特点,分析影响早产结局的相关因素。结果两组的Ro-52抗体阳性、抗磷脂抗体阳性及低补体情况有统计学差异(P<0.05),提示Ro-52抗体阳性、抗磷脂抗体阳性、低补体的孕妇更易出现早产。早产分娩组出现血小板减少、蛋白尿、高血压的概率均高于足月分娩组,差异有统计学意义(P<0.05)。二元Logistic回归分析显示,妊娠蛋白尿、合并抗磷脂综合征及妊娠首发SLE是早产的独立危险因素(P<0.05)。结论SLE妊娠的早产率、早产儿死亡率、窒息风险均较高,对于孕期首发SLE患者需要提高警惕以避免早产结局,治疗性早产是预防重点。

Objective To investigate the clinical characteristics of preterm pregnancy outcome in patients with systemic lupus erythematosus(SLE)complicated with pregnancy.Methods Clinical data of 204 SLE patients with pregnancy were retrospectively collected,including age,pregnancy and delivery times,medication status and laboratory test indicators.According to the pregnancy outcome,they were divided into the preterm delivery group(86 cases)and the tenn delivery group(118 cases).The clinical characteristics of the two groups were compared,and the related factors affecting the outcome of preterm delivery were analyzed.Results The positive Ro-52 antibody,anti-phospholipid antibody and low complement were statistically different between the two groups(P<0.05),suggesting that pregnant women with positive Ro-52 antibody,anti-phospholipid antibody and low complement were more likely to have premature birth.The probability of thrombocytopenia,proteinuria and hypertension in preterm delivery group was higher than that in term delivery group,and the difference was statistically significant(P<0.05).Binary Logistic regression analysis showed that proteinuria during pregnancy,antiphospholipid syndrome and first-episode SLE during pregnancy were independent risk factors for pretemi birth(P<0.05).Conclusion The preterm birth rate,premature mortality rate and asphyxia risk of SLE pregnancy are all high.For patients with first-episode SLE during pregnancy,we need to be vigilant to avoid the outcome of pretemi birth,and therapeutic preterm birth is the focus of prevention.