系统性红斑狼疮合并妊娠14例临床分析  

Clinical analysis of complications and outcome of pregnant women with systemic lupus erythematosus

作　　者：李莉敏 王芳[2] 程永静[2] 黄慈波[2] 

机构地区：[1]河北省涞源县医院妇产科,保定074300 [2]卫生部北京医院风湿免疫科

出　　处：《中国临床保健杂志》2011年第5期477-479,共3页Chinese Journal of Clinical Healthcare

摘　　要：目的分析并探讨系统性红斑狼疮(SLE)患者的妊娠情况,孕期产期并发症及妊娠结局。方法回顾性分析卫生部北京医院收治的14例系统性红斑狼疮合并妊娠患者的临床资料,分析妊娠对SLE患者病情的影响及对母亲胎儿的影响。结果 14例患者中,3例(21%)患者妊娠诱发系统行红斑狼疮发病,5例(36%)患者妊娠诱发系统性红斑狼疮活动,其余6例病情稳定(43%)。14例患者中,3(21%)例流产,11(79%)例分娩。在11例(72%)成功分娩者中,有4例(29%)患者母婴平安。7例(50%)出现围生期母婴并发症,新生儿出现1例胎盘血流灌注,2例宫内窘迫,1例低体质量儿;产妇1例出现左心力衰竭,1例妊娠高血压,2例贫血,产后出血。病情活动组患者的SLE疾病活动指数最高值,母婴并发症发生的例数均明显高于病情稳定组(均P<0.05)。结论 SLE妊娠后可诱发系统性红斑狼疮发病及病情活动,围生期可能出现母儿并发症。Objective To investigate complications and perinatal outcome of pregnant women with systemic lupus erythematosus （SLE）. Methods Retrospective analysis of 14 cases of pregnant women with SLE was done. The factors that may influence complications and perinatal outcome were studied. Results Among the 14 cases,3（21% ） were diagnosed as SLE for the first time, and disease activity index elevated in 4 （29%） , while the other 7 （50%） keeped stable. As for the outcome of pregnancy, 3 （21% ）experienced miscarriage, while the other 11 delivered suc- cessfully. 4 of those 11 cases had no complications,while the other 7 experienced complications either in neonates or mothers. Complications in neonates included placenta perfusion （1 ease）, fetal distress （2 cases）and low birth weight （ 1 case）. Mothers with complications included 1 case with heart failure, 1 with gestational hypertension and 2 with anemia and postpartum bleeding. The SLEDAI max and complications in mothers and neonates in the disease activity group were much higher than those in the disease stable group （ P 〈 0.05 ）. Conclusion Pregnant women with SLE should be considered as a high risk group, even those condition was stable before pregnancy. A close monitoring for SLE patients during pregnancy should be necessary.

关 键 词：妊娠 红斑狼疮 系统性 妊娠结局 妊娠并发症 

分 类 号：R714.2[医药卫生—妇产科学]