体外受精和胚胎移植后妊娠合并急性粟粒性肺结核的临床特点  

Retrospective analysis of 6 cases of miliary tuberculosis in pregnant women after in vitro fertilization and embryo transfer

作　　者：高惠娟[1] 胡燕军[1] 朱依敏[1] 黄荷凤[1] 

机构地区：[1]浙江大学医学院附属妇产科医院生殖中心,杭州310006

出　　处：《中华结核和呼吸杂志》2007年第11期848-850,共3页Chinese Journal of Tuberculosis and Respiratory Diseases

摘　　要：目的总结体外受精和胚胎移植(IVF-ET)后妊娠发生急性粟粒性肺结核的临床特点。方法回顾性分析2001年1月至2005年12月在浙江大学医学院附属妇产科医院生殖中心接受IVF-ET 后妊娠并发粟粒性肺结核的6例临床资料。结果 IVF-ET 后妊娠并发粟粒性肺结核患者的临床表现多不典型,以发热为主要表现,呼吸道症状隐匿。胸部影像学表现以粟粒性结节和浸润性改变为主。平均于移植后53.2 d 发病,1例人工流产终止妊娠,其余5例均在发病后2～4周内发生自然流产。结论发热为急性粟粒性肺结核的主要临床表现,IVF-ET 后妊娠发生粟粒性肺结核的妊娠结局差,对抗炎治疗无效的发热患者应警惕肺结核,尽早行结核病的相关检查。Objective To analyze the clinical characteristics of haematogenous disseminated tuberculosis in pregnant women after in vitro fertilization and embryo transfer （IVF-ET）. Methods Six cases of haematogenous disseminated tuberculosis after in vitro fertilization pregnancy from January 2001 to December 2005 were retrospectively analyzed. Results The clinical manifestations of pulmonary miliary tuberculosis were non-specific. All cases presented with fever for several weeks, but typical respiratory manifestations were lacking. Chest X-ray showed typical miliary and infiltrate lesions. The onset of fever was at an average of 53. 2 days after embryo transfer. Miscarriage occurred in 5 patients within 2 to 4 weeks after the onset of fever. Condnsion The main symptom of miliary tuberculosis in pregnant women after IVF-ET was fever, and the prognosis of the pregnancy was poor. Physician should be alert to the occurrence of haematogenous disseminated tuberculosis, especially in pregnant women with long-term fever.

关 键 词：结核 粟粒性 胚泡移植 妊娠结局 

分 类 号：R521[医药卫生—内科学] R714.8[医药卫生—临床医学]