妊娠合并系统性红斑狼疮患者孕期并发症及妊娠结局的临床分析  

Clinical analysis of the complication and outcome in pregnant patients with systemic lupus erythematosus

作　　者：王大鹏[1] 梁梅英[1] 张晓红[1] 

机构地区：[1]北京大学人民医院妇产科,100044

出　　处：《中国妇产科临床杂志》2010年第6期426-429,共4页Chinese Journal of Clinical Obstetrics and Gynecology

摘　　要：目的分析并探讨系统性红斑狼疮(SLE)患者的孕期并发症情况及妊娠结局。方法回顾性分析2000年1月至2010年3月北京大学人民医院收治的19例妊娠合并SLE患者的临床资料,对影响SLE合并妊娠并发症的相关因素和SLE不同妊娠时机的妊娠结局进行分析。结果 19例患者中11例(11/19,57.9%)出现了母儿并发症,4例重度子痫前期,1例流产,2例死胎,2例足月低出生体重,4例早产。无并发症组8例,两组患者的孕产次及孕前病程、分娩方式无明显差异,但无并发症组患者的年龄小于并发症组,分娩孕周明显延长,新生儿体重明显增加,两组差异有统计学意义(P=0.006);孕前病情的稳定程度对孕期母儿并发症的影响差异无统计学意义(P=0.633);但妊娠前病情稳定大于6个月的患者出现并发症的比例较低(6/12,50.0%vs5/7,71.4%)。3例妊娠期间诊断SLE的患者均在孕期或产后出现了严重的并发症,1例(1/3,33.3%)新生儿诊断为SLE;与孕前病情控制平稳>6个月的患者相比,分娩孕周较小,新生儿体重较低(P<0.05)。结论 SLE患者即使孕前病情控制平稳,妊娠后仍有可能出现严重的母儿并发症。在病情控制平稳后妊娠,孕期在产科和风湿科医师的共同严密监测下,坚持治疗,适时终止妊娠是改善母婴结局的关键。同时应注意提高对妊娠期SLE的诊断。Objective To investigate the complication and the perinatal outcome of pregnancy with systemic lupus erythematosus（SLE）.Methods Clinical data of 19 pregnant women with SLE were analyzed retrospectively.Factors that may influence pregnancy complications and perinatal outcomes were studied.Results Among the 19 patients,11（11/19,57.9%）cases who had different complications including 4 severe preeclampsia,1 miscarriage,2 stillbirth,2 low birth weight and 4 preterm birth constituted complication group.Other 8 cases who had no complications were in no complication group.There were no significant differences between the two groups in gestation numbers,parity and history of SLE before pregnancy,but those without complications were younger and had longer gestational age compared with complication group,and their birth weight were higher,the difference was significant.The stability condition before pregnancy had no significant impact on the complications（P=0.633）,but for those with stable condition more than 6 months before pregnancy,the proportion of complications was lower（6/12,50% vs 5/7,71.4%）.All the three cases of SLE patients diagnosed during pregnancy had serious complications whether during pregnancy or postpartum,1（1/3,33.3%）neonatal was diagnosed SLE.Conclusions Pregnant women with SLE should be considered as a high-risk,even in those with stable condition before pregnancy.Improving the first diagnosis of SLE during pregnancy is necessary.

关 键 词：系统性红斑狼疮 妊娠 并发症 

分 类 号：R714.25[医药卫生—妇产科学]