| 妊娠合并系统性红斑狼疮61例临床分析 |
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| 引用本文： | 邓冉冉,李增彦. 妊娠合并系统性红斑狼疮61例临床分析[J]. 国际妇产科学杂志, 2017, 44(1): 95-98. DOI: 10.3969/j.issn.1674-1870.2017.01.024 |
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| 作者姓名： | 邓冉冉 李增彦 |
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| 作者单位： | 300052,天津医科大学总医院妇产科 |
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| 摘 要： | 目的:探讨系统性红斑狼疮(SLE)对妊娠并发症、妊娠结局、分娩方式的影响。方法:回顾性分析天津医科大学总医院2010年1月1日—2015年12月31日收治的61例妊娠合并SLE患者的临床资料,根据SLE妊娠时机及孕前临床表现、实验室检查等分为SLE稳定组(35例)和SLE活动组(26例),并对2组的妊娠并发症、妊娠结局、分娩方式进行比较。结果:(1)在妊娠并发症方面,SLE活动组子痫前期的发生率显著高于稳定组(58%vs.0,P=0.000),胎膜早破、胎儿窘迫、胎儿生长受限、产后出血、羊水过少的发生率差异均无统计学意义(P>0.05)。(2)在妊娠结局及分娩方式方面,SLE活动组早产(50%vs.20%,P=0.014)、低出生体质量儿(50%vs.20%,P=0.014)、中期引产(27%vs.3%,P=0.018)的发生率均高于SLE稳定组,但2组的早产低出生体质量儿、足月产低出生体质量儿发生率比较差异无统计学意义(P=0.270)。SLE活动组自然分娩率低于稳定组(0 vs.43%,P=0.000)。2组间死胎剖宫产的发生率比较差异均无统计学意义(P>0.05)。(3)孕期发现的4例SLE患者,其中2例是由于反复胎心率波动于115~125次/min之间,于我院风湿科门诊就诊,确诊为SLE。结论:SLE孕产妇属于高危妊娠患者,孕期应密切监测SLE患者的临床表现,血压,以及尿蛋白、肝肾功能、免疫学指标等实验室检查指标,及时发现SLE病情活动情况,及时处理,以减少妊娠并发症及不良结局。孕期发生子痫前期时应排除SLE,对于孕期反复胎心率低的孕产妇也应警惕合并SLE。
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| 关 键 词： | 妊娠 红斑狼疮 系统性 妊娠并发症 妊娠结局 分娩 |
Clinical Analysis of 61 Pregnancies with Systemic Lupus Erythematosus |
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| DENG Ran-ran,LI Zeng-yan. Clinical Analysis of 61 Pregnancies with Systemic Lupus Erythematosus[J]. Journal of International Obstetrics and Gynecology, 2017, 44(1): 95-98. DOI: 10.3969/j.issn.1674-1870.2017.01.024 |
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| Authors: | DENG Ran-ran LI Zeng-yan |
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| Abstract: | Objective: To explore the systemic lupus erythematosus (SLE) with respect to obstetric complications, pregnant outcomes and the manner of delivery. Methods:We reviewed the medical records of SLE pregnant women treated from January 1, 2010 to December 31, 2015 in Tianjin Medical University General Hospital. According to clinical manifestation, laboratory examination, before pregnancy, the patients is divided into the SLE stable group (35 cases) and SLE active group (26 cases), and compared between the two groups in the form of pregnancy complications, outcomes and delivery. Results: ①In terms of pregnancy complications, the incidence of pre-eclampsia in SLE active group was obviously higher than that in SLE stable group group (58% vs. 0,P=0.000). The incidence of premature rupture of membranes, fetal distress, fetal growth restriction, postpartum hemorrhage and oligohydramnios has no statistically significant differences between the two groups (P>0.05).②In expect of pregnant outcomes and the manner of delivery, the incidence of prematurity(50%vs. 20%,P=0.014), low birth weight infant(50%vs. 20%,P=0.014), therapeutic abortion(27%vs. 3%,P=0.018)in SLE activity group was statistically higher than that in SLE stable group. However, there was not statistically significant difference in the incidence of low birth weight infant with preterm birth and with term birth (P=0.270). The spontaneous labor rate of SLE active group was statistically higher than that of SLE stable group (0 vs. 43%,P=0.000). The incidence of stillbirth and cesarean delivery has no statistically significant difference between the two groups (P>0.05).③Two patients from four patients with SLE found in pregnancy were diagnosed with lupus in the department of rheumatology clinic due to repeated fetal heart rate fluctuation between 115-125 bpm. Conclusions: Pregnant women with SLE are high-risk patients. Clinical manifestations, blood pressure, and laboratory examination, such as urinary protein, kidney function, immunological indexes, should be closely monitored during pregnancy. So, we can find SLE disease activity on time and timely treatment in order to reduce the incidence of pregnancy complications and adverse outcomes. It is worth noting that pre-eclampsia occurring during pregnancy should be distinguished with SLE, and for repeated low heart rate of maternal pregnancy should also be alert to merge SLE. |
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| Keywords: | Pregnancy Lupus erythematosus,systemic Pregnancy complications Pregnancy outcome Parturition |
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