妊娠合并系统性红斑狼疮死亡6例分析  

Analysis of six maternal deaths due to systemic lupus erythematosus

作　　者：于莹[1] 沈汝冈[1] 刘凯波[1] 杨惠娟[1] Yu Ying;Shen Rugang;Liu Kaibo;Yang Huijuan(Department of Perinatal Care,Beijing Obstetrics and Gynecology Hospital,Capital Medical University(Beijing Maternal and Child Health Care Hospital),Beijing 100026,China)

机构地区：[1]首都医科大学附属北京妇产医院(北京妇幼保健院)围产保健科,北京100026

出　　处：《中华围产医学杂志》2023年第10期847-851,共5页Chinese Journal of Perinatal Medicine

基　　金：首都卫生发展科研专项项目(2018-2-2111)。

摘　　要：目的探讨妊娠合并系统性红斑狼疮(systemic lupus erythematosus, SLE)死亡病例的临床特点。方法回顾性分析2012年1月1日至2021年12月31日北京市妇幼保健监测数据中6例妊娠合并SLE死亡病例, 收集孕产妇基本信息、现病史、既往史、产前检查情况、诊疗经过、评审意见及死亡诊断等内容进行分析。采用描述性方法对数据进行分析。结果十年间北京市妊娠合并SLE死亡6例, 死亡率为0.28/10万(6/214.3万)。这6例中, 主要临床表现为发热、神经精神和呼吸系统症状;均存在血小板计数(platelet count, PLT)降低及低补体血症。3例孕期血压增高, 5例有尿蛋白, 3例孕期合并感染。无SLE病史的3例中, 主要脏器损害为血液系统、肺和肾脏;有SLE病史的3例中, 神经精神、血液系统和肾脏是主要受累脏器。结论本组妊娠合并SLE死亡病例的发病症状主要包括发热、神经精神和呼吸系统症状, 高血压和感染为常见的并发症, PLT减少、尿蛋白以及补体降低也是重要的实验室指标。Objective To explore the clinical characteristics of deceased cases due to pregnancy complicated by systemic lupus erythematosus(SLE).Methods A retrospective analysis was conducted on six cases of pregnancy-related deaths due to SLE from January 1,2012 to December 31,2021 in Beijing Maternal and Child Health Monitoring Data.Information including basic details of the pregnant women,medical histories,prenatal examinations,diagnostic and treatment processes,review opinions,and causes of death were collected from their medical records,death investigation reports,and municipal-level maternal mortality review.Descriptive methods were used to analyze the data.Results Between 2012 and 2021,the mortality of pregnancy combined with SLE in Beijing was 0.28/100000.Among these six cases,the primary clinical manifestations were fever,neuropsychiatric,and respiratory symptoms.All had a decreased platelet count(PLT)and exhibited hypocomplementemia.Three cases experienced elevated blood pressure during pregnancy,five had proteinuria,three had infections during pregnancy.Among the three cases without a history of SLE,the primary organ damages were in the hematological system,lungs,and kidneys.For the three cases with a history of SLE,the primary affected organs were the neuropsychiatric system,hematological system,and kidneys.Conclusions The initial symptoms of the cases in this group primarily involved fever,neuropsychiatric,and respiratory symptoms.Hypertension and infections were common complications,and decreased PLT,proteinuria,and reduced complement levels were also significant laboratory indicators.

关 键 词：妊娠并发症 红斑狼疮 系统性 产妇死亡率 回顾性研究 

分 类 号：R714.2[医药卫生—妇产科学]