66例系统性红斑狼疮患者67次妊娠特点及妊娠结局分析

doi:10.6040/j.issn.1671-7554.0.2014.772

摘要/Abstract

摘要： 目的探讨妊娠合并系统性红斑狼疮(SLE)患者孕期病情活动的临床特点及对妊娠结局的影响。方法收集并回顾性分析2005年8月至2014年8月就诊于山东大学齐鲁医院的66例妊娠合并SLE患者67次妊娠(计为67例,非活动组31例,活动组36例)的临床资料。结果妊娠合并SLE患者活动组的早产率、小于胎龄儿发生率、治疗性流产率、总妊娠丢失率及重度子痫前期发生率较非活动组明显增高(P<0.05)。且SLE病情活动多发生于妊娠中晚期,以蛋白尿、皮疹的发生率最高,多表现为多器官、多系统受损,肾脏尤甚。而妊娠早期,SLE活动的临床表现以血液系统损害多见,或(和)出现皮疹等。结论 SLE孕期活动主要累及患者的血液系统及肾脏,可导致不良母儿结局风险增加,但大多数SLE患者能获得良好的妊娠结局。建议SLE患者行计划妊娠,孕前疾病稳定至少6个月以上,孕期密切监测,及早发现疾病活动并及时治疗。

关键词: 临床特点, 红斑狼疮,系统性, 妊娠结局, 妊娠

Abstract: Objective To investigate the clinical characteristics and pregnancy outcomes of patients with systemic lupus erythematosus (SLE). Methods Clinical datas of 66 pregnant women with 67 pregnancies (36 cases in flare group and 31 cases in non-flare group) with SLE treated in our hospital during Aug. 2005 and Aug. 2014 were collected and retrospectively analyzed. Results The incidence rates of preterm birth, small for gestational age infant, therapeutic abortion, pregnancy loss and severe preeclampsia increased significantly in the flare group compared with the non-flare group (all P<0.05). SLE was mostly active in the middle and late pregnancy, with the highest rate of proteinuria and skin rash, which were involved with multi-organ and multi-system damage, especially kidney damage. SLE flare in early pregnancy harmed the blood system, with or without skin rash. Conclusion SLE flare can lead to damage of the blood system, kidney and increased risks of poor fetal and maternal outcomes. Thus, for a better outcome of lupus pregnancy, it is essential to make a thoughtful plan, ensure a stable condition for at least 6 months before conception, and monitor the clinical indexes closely during pregnancy.

Key words: Pregnancy, Lupus Erythematosus, Systemic, Clinical characteristics, Pregnancy outcomes

中图分类号:

R714.25

王立葵, 桑洪爱, 马玉燕, 徐银涛, 王琳琳. 66例系统性红斑狼疮患者67次妊娠特点及妊娠结局分析[J]. 山东大学学报（医学版）, 2014, 52(12): 69-72.

WANG Likui, SANG Hongai, MA Yuyan, XU Yintao, WANG Linlin. Clinical characteristics and pregnancy outcomes of patients with systemic lupus erythematosus: a study of 66 cases with 67 pregnancies[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2014, 52(12): 69-72.

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