寻常型天疱疮患者合并妊娠八例分析  

Pemphigus vulgaris in pregnancy： eight case reports

作　　者：高昱[1] 王明悦[1] 朱学骏[1] 陈喜雪[1] 

机构地区：[1]北京大学第一医院皮肤科,100034

出　　处：《中华皮肤科杂志》2015年第1期45-47,共3页Chinese Journal of Dermatology

基　　金：国家自然科学基金重点项目（81130030）;国家自然科学基金青年科学基金（81000694）

摘　　要：目的 探讨寻常型天疱疮与妊娠、分娩及对新生儿的影响.方法 收集就诊并随访的8例寻常型天疱疮合并妊娠患者的临床资料.结果 1例妊娠晚期发病;7例为经过治疗的患者,妊娠前皮肤黏膜损害已完全消退,其中6例泼尼松用量＜ 10 mg/d,1例为22.5 mg/d.妊娠结果：1例失访;1例妊娠40余天时行人工流产,病情无波动;6例足月分娩正常体重新生儿,其中1例在妊娠中期病情波动,1例因自行停药分娩后2个月病情复发,其余4例患者病情稳定.新生儿情况：6例新生儿中4例体健,2例出生时有新生儿天疱疮,外用药后痊愈.结论 寻常型天疱疮患者在疾病完全控制、停用免疫抑制剂、糖皮质激素用量较小时可安全妊娠、分娩.新生儿虽然有发生天疱疮的风险,但预后好.Objective To investigate the effects of pemphigus vulgaris （PV） on pregnancy,childbirth and neonates.Methods Clinical data were collected from 8 pregnant patients with PV who visited the Peking University First Hospital and received follow up.Results Of these patients one developed PV in the third trimester of pregnancy,and the other 7 received treatment for PV and achieved complete subsidence of mucocutaneous lesions before pregnancy.Among the 7 cases,6 were treated with prednisone 〈 10 mg/d,and 1 was treated with prednisone 22.5 mg/d.Finally,1 patient was lost to follow-up,1 patient underwent artificial abortion on about day 40 of pregnancy with no fluctuation in disease activity.Six patients delivered a normal birth weight baby at term,of whom,1 experienced fluctuation in disease activity in mid-pregnancy,1 suffered from recurrence of PV as a result of drug withdrawal at 2 months after delivery,and the other 4 showed no changes in disease activity.Four out of six neonates were healthy,while two were born with neonatal PV and healed after topical treatment.Conclusions Safe pregnancy and delivery can be achieved in patients with PV whose condition is completely under control with lowdose glucocorticoids after withdrawal of immunosuppressive agents.Although there is a risk of PV in neonates,the prognosis is optimistic.

关 键 词：寻常型天疱疮 妊娠 新生儿 

分 类 号：R758.66[医药卫生—皮肤病学与性病学]