妊娠合并系统性红斑狼疮的分娩结局  

OUTCOME OF LUPUS PREGNANCY

作　　者：张颖[1] 谭丽君[1] 汤凤姿[1] 

机构地区：[1]中山大学附属第一医院妇产科,广东510080

出　　处：《中国现代医学杂志》2003年第3期58-59,68,共3页China Journal of Modern Medicine

摘　　要：目的 :探讨妊娠与系统性红斑狼疮的相互影响作用 ,并提出妊娠合并系统性红斑狼疮的孕期监护内容。方法 :将 2 5例妊娠合并系统性红斑狼疮患者 ,按病程分为初次发病、活动期 ,控制期 ,缓解期 3种状态 ,分析其妊娠丢失率、早产率及其产时及产后的监护和处理。结果 :妊娠合并系统性红斑狼疮妊娠丢失率为 4 5 .2 %(14 /31) ,SLE活动期妊娠丢失率为 10 0 % (9/9) ,与控制期 13.3% (2 /15 )和缓解期 14 .3% (1/7)相比明显升高(P <0 .0 5 ) ;控制期和缓解期妊娠者妊娠丢失率无显著差异 (P >0 .0 5 ) ,控制期早产率 33.3% (5 /15 )较缓解期 14 .3% (1/6 )明显升高P <0 .0 5。 2 5例中 12例产后病情恶化 (38.7% )。结论 :妊娠合并SLE可以诱发或加重SLE活动。活动期受孕者妊娠结果最差 ,其次为妊娠期发病者 ,控制期和缓解期妊娠结果较好。如病情较重 ,治疗后未能缓解 ,应做好避孕或及时中止妊娠。孕期加强监测。根据病情需要应用激素。Objective:To investigate the interaction effect between pregnancy and systemic lupus erythematosus.Methods:We divided 25 cases of lupus pregnancy into active stage, control stage and abatement stage. The rates of pregnant loss and premature labor were analyzed.The management methods before and after labor were construed at the same time.Results:The pregnant loss rate of lupus pregnancy was 45.2% .It was 100% in active stage, while it was 13.3% in control stage and 14.3% in abatement stage respectively( P <0.05).The premature delivery rate was 33.3% in control stage, while it was 14.3% in abatement stage ( P <0. 05).Conclusions:Lupus pregnancy would aggravate SLE.The outcome of active stage is the worst while the outcome of control and abatement stage is better. If the state of SLE is severe or the disease could not be controlled, the pregnancy should be ceased. Predisone should be used according to the stage of SLE in pregnancy.

关 键 词：妊娠 合并症 系统性红斑狼疮 分娩结局 

分 类 号：R714.259[医药卫生—妇产科学] R593.241[医药卫生—临床医学]