系统性红斑狼疮合并妊娠(附3例分析并文献复习)

目的探讨系统性红斑狼疮(SLE)合并妊娠后患者与胎儿可能发生的不良情况及应该采取的措施.方法分析3例SLE合并妊娠患者与胎儿的临床表现、治疗原则和预后,并复习有关文献.结果3例SLE合并妊娠患者中2例早产,但胎儿均存活(分别为37周与31周行剖宫产),另1例26周时并发狼疮肾病与狼疮脑病,于羊膜腔内注射利凡诺(药物终止妊娠),随后顺产1死婴.成活的2例新生儿(男女各1)分别为ANA( )与SSA( ).3例患者在终止妊娠时均加大皮质激素的用量,其中2例加用环磷酰胺.结论SLE合并妊娠增加了患者的合并症和危险性,并使胎儿早产率及致死率增高;合并重要并发症(如脑病)的SLE患者应终止妊娠;无论以何种方式分娩出胎儿,均应对生产前后的SLE患者加强治疗.

Systemic lupus erythematosus complicated with pregnancy (analysis of 3 cases and reference review)

Objective To study the unwanted effects of systemic lupus erythematosus (SLE) patients on pregnancy and the fetus.The corresponding management measures were explored.Methods The clinical manifestation,treatment and prognosis of SLE patients with pregnancy and their fetus were analyzed and the related literatures were reviewed.Results Two of three SLE patients with pregnancy had experienced premature delivery cesarean section was performed in 37th week and 31th week respectively,the another patient complicated with lupus nephritis and cerebral disease in the 26th week and had experienced medical termination of pregnancy.One fetus was dead,but the other two alive infants were ANA and anti SSA antibody positive.High dose of steroid was used in all three patients in pregnancy termination,cyclophosphamide was used in two of them.Conclusions SLE patients with pregnancy have more complications and more dangerous than normal pregnancy.The rate of premature delivery and mortality are high.Pregnancy should be terminated in SLE patients complicated with fatal disease (cerebral disease etc.).The treatment should be strengthened during peri delivery period either in natural or in induced delivery.