视神经脊髓炎谱系病合并妊娠患者的免疫机制与治疗

Clinical and medication analysis of pregnancy in neuromyelitis optica spectrum disorders

视神经脊髓炎谱系病(NMOSD)是免疫介导的中枢神经系统炎性脱髓鞘疾病,好发于女性,发病的中位年龄是39岁,有大约一半的患者是在育龄期。既往研究认为妊娠会导致疾病的恶化或复发,疾病本身对妊娠有负面影响。近年来,随着疾病妊娠免疫研究的积累和临床数据的总结,患者有望在合理的用药和监测下完成安全的妊娠过程和获得良好的母婴结局。目前没有明确的关于NMOSD妊娠期治疗的指南,患者妊娠全程建议由神经内科神经免疫、高危产科、新生儿科专家组成的诊疗中心参与,以确保NMOSD患者妊娠期的个性化治疗和护理。本文对视神经脊髓炎谱系病合并妊娠患者的免疫与用药进行综述,旨在为临床用药提供参考。

Neuromyelitis optica spectrum disorders are immune-mediated inflammatory demyelinating diseases of the central nervous system that occur in women,partly in the reproductive years.Previous studies have suggested that pregnancy can lead to worsening or recurrence of the disease and also has a negative impact on pregnancy.In recent years,with the accumulation of disease pregnancy immunization studies and the summary of clinical data,patients are expected to complete a safe pregnancy course and achieve good maternal and infant outcomes with reasonable medication and monitoring.There are no clear guidelines for the treatment of NMOSD during pregnancy,a treatment center consisting of neuroimmunologist,high-risk obstetrics,and neonatology specialists is recommended throughout the patient’s pregnancy to ensure individualized treatment and care of NMOSD patients during pregnancy.