妊娠合并系统性红斑狼疮的临床分析  

Clinic Analysis of Pregnancy Complicated with Systemic Lupus Erythematosus

作　　者：张建瑜[1] 黄凯清[2] 李婷[1] 

机构地区：[1]广州医学院第三附属医院血液风湿科,广州市510150 [2]广州医学院第三附属医院妇产科,广州市510150

出　　处：《中华全科医学》2012年第7期1030-1032,共3页Chinese Journal of General Practice

摘　　要：目的探讨妊娠合并系统性红斑狼疮(SLE)患者孕期病情活动情况,及其与妊娠结局、产科并发症的关系。方法对2006～2011年收治的51例次妊娠合并SLE的49名患者临床资料进行回顾性分析。结果①根据SLE活动与否分为A组和B组:临床无SLE活动,妊娠前1年不用糖皮质激素或泼尼松剂量≤10 mg/d为A组;妊娠前1年内有SLE活动,或妊娠过程SLE首次发病及SLE病情加重为B组。A组患者仅发生微量蛋白尿1例和中度贫血2例;B组以妊娠中期SLE首发及病情加重为主,主要损害肾脏和血液系统;并发生产妇死亡一例及重度先兆子痫7例。②A组胎儿丢失率(9.1%)明显小于B组(42.5%),早产(20%)和低体重率(27.3%)明显低于B组(分别为60.9%、65.2%),A组新生儿体重明显大于B组,分别为(2661±699)g、(2268±849)g,P均<0.05。结论孕前病情不稳定、孕期泼尼松用药不规范是妊娠合并SLE病情加重的危险因素。不良妊娠结局在孕期SLE活动时明显增加。Objective To investigate the risk factors of systemic lupus erythematosus（SLE） during pregnancy,and its relationship with pregnancy outcomes and obstetric complications.Methods Clinical data of 51 pregnant women with SLE from 2006 to 2011 was analyzed retrospectively.Results ①SLE fare was found in patients with unstable SLE status progestational,pregnancy before SLE initially onset,SLE patients using prednisone irregularly.Active SLE was found in 11 cases（Group A） and active in 40 cases（Group B）.②SLE damage in the Group A included 1 case of proteinuria and 2 cases of anemia.In group B,SLE flare was mainly found in the second trimester,which resulted in lupus nephritis and blood system injuries.One case of maternal death and 7 cases of preeclampsia was reported.③The rate of fetal loss,premature labor and low neonates weight was 9.1%,20% and 27.3% in group A were better than those corresponding rate in group B（42.5%,60.9% and 65.2%） significantly（P0.05）.The neonates weight in group A（2661±699 g） was better significantly than that in group B（2268±849 g）,P0.05.Conclusion Adverse maternal and fetal outcomes should increase after SLE onset.Unstable progestational SLE status and irregular use of prednisone are the important risk factors of SLE flare.

关 键 词：妊娠 系统性红斑狼疮 

分 类 号：R593.241[医药卫生—内科学]