妊娠合并混合性结缔组织病临床分析  

The clinical analysis of pregnancies complicated with mixed connective tissue disease

作　　者：王大鹏[1,2] 梁梅英 WANG Dapeng, LIANG Meiying.(Department of Obstetrics and Gynecology, People＇s Hospital, Peking University, Beijing 100044, Chin)

机构地区：[1]北京大学人民医院妇产科,100044 [2]北京圣宝妇产医院

出　　处：《中国妇产科临床杂志》2018年第3期208-210,共3页Chinese Journal of Clinical Obstetrics and Gynecology

摘　　要：目的探讨妊娠合并混合性结缔组织病（MCTD）的孕产期处理和妊娠结局。方法回顾性分析北京大学人民医院2006年1月至2016年1月问收治及分娩的合并MCTD患者的临床资料，并电话随访母儿情况。结果共有4例孕妇5次分娩纳入分析，子痫前期发生率20％（1／5），血小板减少40％（2／5），肺动脉高压40％（2，5），其中1例剖宫产后死亡。活产儿5个，平均分娩孕周35．9周，平均体重2556g，剖宫产率80％（4／5）。早产率60％（3／5），胎儿生长受限20％（1／5），新生儿狼疮40％（2／5）。4例MCTD患者，1例死亡，其余3例随访1—5年疾病未发生转化。1例新生儿失访，其余4例目前无免疫相关疾病。结论MCTD患者的母儿预后与孕前病情程度、孕期是否坚持治疗以及综合保健水平密切相关。Objectives To investigate the clinical treatment of pregnancies complicated with mixed connective tissue disease （MCTD） and the perinatal outcomes. Methods The medical records of all pregnant patients with a diagnosis of MCTD treated at Peking University People＇s Hospital from 2006 to 2016 were reviewed. The conditions of all the mothers and the infants were followed. Results 5 pregnancies occurring in 4 women with MCTD were identified. The overall incidence rate of preeclampsia was 20%, thrombocytopenia 60%, pulmonary artery hypertension （PAl-I） 30%, and 1 women complicated PAll died after cesarean section. All 5 pregnancies resulted in live births. Mean gestational age was 35.9 weeks. All but one infants were delivered by C-section. Mean birthweight was 2 556 g. The incidence rate of preterm delivery was 40% and fetal growth restriction was 20%. 2 infants were diagnosed neonatal lupus, one presented as erythematous papules and another manifested severe anemia. During 1 ~ 5 years＇ follow-up, the 3 survived women were complicated with MCTD steadily. Only 1 neonate was lost, the others did not have any manifestation of immtme system disease. Conclusion The perinatal outcomes of MCTD patients were closely related to the degree of the pre-pregnancy condition, the persistence of treatment in pregnancy and the level of comprehensive health care.

关 键 词：妊娠 混合性结缔组织病 

分 类 号：R714.25[医药卫生—妇产科学]