风湿免疫疾病患者妊娠期及哺乳期的用药风险评估  

Risk Assessment of Medication in Patients with Rheumatic Immune Disease during Pregnancy and Lactation

作　　者：蒋萌[1] 狄文(审校)[1] JIANG Meng;DI Wen(Department of Obstetrics and Gynecology,Ren Ji Hospital,School of Medicine,Shanghai Jiao Tong University,Shanghai Key Laboratory of Gynecologic Oncology,State Key Laboratory of Oncogenes and Related Genes,Shanghai Cancer Institute,Shanghai 200127,China)

机构地区：[1]上海交通大学医学院附属仁济医院妇产科,上海市妇科肿瘤重点实验室,癌基因及相关基因国家重点实验室,200127

出　　处：《国际妇产科学杂志》2020年第6期657-661,共5页Journal of International Obstetrics and Gynecology

基　　金：上海市临床重点专科项目。

摘　　要：风湿免疫疾病易累及多脏器,妊娠及分娩可能加重病情而危及患者生命。随着现代医学不断进步以及多学科协作,风湿免疫疾病不再是妊娠禁忌证;同时,母乳喂养不论对母儿健康还是家庭经济都是积极有益的。风湿免疫疾病患者的用药安全既要考虑到疾病本身,同时也要兼顾到孕前、妊娠期母婴安全以及母乳喂养儿发育健康的双重需要。常用的抗风湿免疫药物主要包括糖皮质激素、羟氯喹、非甾体抗炎药物、免疫抑制剂和生物制剂等,不同药物在妊娠期和哺乳期的应用各有不同。因此,抗风湿免疫药物在育龄期女性中应用的安全性应得到更多的关注。掌握常用药物对子代的影响作用及安全剂量范围,有助于为妊娠期及哺乳期用药指导提供更多的理论依据。Rheumatic immune diseases usually involve multiple organs.Pregnancy and childbirth may aggravate the condition and endanger the life of patients.With the development of modern medicine and multi-disciplinary cooperation,rheumatic immune disease is no longer a contraindication for pregnancy.Meanwhile,breastfeeding is beneficial to both maternal and child health and family economy.The medication safety of patients with rheumatic immune disease should consider not only the disease itself,but also the safety of mothers and infants before and during pregnancy,as well as the development and health of breast-feeding children.The commonly used anti-rheumatic immune drugs include glucocorticoids,hydroxychloroquine,non-steroidal anti-inflammatory drugs,immune-suppressants and biological agents.Different drugs have different applications in pregnancy and lactation.Therefore,more attention should be paid to the safety of anti-rheumatic immune drugs in women of childbearing age.To have a good grasp of the influence of the medication on offspring and the safe dosage range is helpful to provide more theoretical basis for the guidance of drug use during pregnancy and lactation.

关 键 词：结缔组织疾病 妊娠 母乳喂养 胎儿发育 药物疗法 危险性评估 

分 类 号：R593.2[医药卫生—内科学]