CAJ | 학술논문

目的探讨系统性红斑狼疮(SLE)患者妊娠的安全性、妊娠结局及对子代的影响.方法回顾性分析1999年6月至2009年10月我院收治的SLE合并妊娠的患者的妊娠情况,比较选择性妊娠和非选择性妊娠组患者的SLE疾病活动情况、产科并发症情况、胎儿情况.并对SLE患者的子代进行随访.统计学处理采用x2检验和t检验.结果 SLE合并妊娠的患者共62例,选择性妊娠组43例,非选择性妊娠组19例;选择性妊娠组中10例(23%)患者在妊娠过程中出现疾病活动,8例(19%)流产,35例(81%)活胎分娩,其中低体质量儿7例,早产7例;非选择性妊娠组中16例(84%)出现疾病活动,13例(68%)流产,6例(32%)活胎分娩,均为低体质量儿,4例早产,3例合并胎儿生长受限.选择性妊娠组的妊娠过程中疾病活动率、流产率均显著低于非选择性妊娠组(P＜0.05).22例子代随访未发现SLE患儿.结论选择性妊娠组与非选择性妊娠组患者均面临妊娠过程中SLE疾病活动及妊娠结局不良的风险,但是选择性妊娠组患者妊娠期间疾病稳定状况、母婴的预后均优于非选择性妊娠组.
목적 탐토계통성홍반랑창(SLE)환자임신적안전성、임신결국급대자대적영향.방법 회고성분석1999년6월지2009년10월아원수치적SLE합병임신적환자적임신정황,비교선택성임신화비선택성임신조환자적SLE질병활동정황、산과병발증정황、태인정황.병대SLE환자적자대진행수방.통계학처리채용x2검험화t검험.결과 SLE합병임신적환자공62례,선택성임신조43례,비선택성임신조19례;선택성임신조중10례(23%)환자재임신과정중출현질병활동,8례(19%)유산,35례(81%)활태분면,기중저체질량인7례,조산7례;비선택성임신조중16례(84%)출현질병활동,13례(68%)유산,6례(32%)활태분면,균위저체질량인,4례조산,3례합병태인생장수한.선택성임신조적임신과정중질병활동솔、유산솔균현저저우비선택성임신조(P＜0.05).22례자대수방미발현SLE환인.결론 선택성임신조여비선택성임신조환자균면림임신과정중SLE질병활동급임신결국불량적풍험,단시선택성임신조환자임신기간질병은정상황、모영적예후균우우비선택성임신조.
Objective To determine the safety, pregnancy outcome and the affect on neonates in pregnant patients with systemic lupus erythematosus(SLE).Methods Sixty-two pregnant patients with SLE were evaluated retrospectively from 1999 to 2009 in our hospital. These patients were divided into two groups:selective pregnancy group and nonselective pregnancy group. The pregnancy outcomes, fetal outcomes, and lupus activity during pregnancy were compared between the two groups. The children of the SLE patients were followed up. Results There were 43 patients in the selective pregnancies group and 19 patients in nonselective pregnancies group. In the selective pregnancies group, lupus flare occurred in 10 pregnancies(23%), 35(81%)had a live birth, 7 had low birth weight infants and 7 had premature delivery; however, in the nonselective pregnancies group, lupus flare occurred in 16 pregnancies(84%), 13(68%) had abortion,6 had a live birth, but all neonates were low birth weight infants. The rates of lupus flare and pregnancy loss in the nonselective pregnancy group were higher than those of the selective pregnancy group(P＜0.05). None of the 22 children had SLE during the follow-up period. Conclusion Both selective and nonselective pregnancy may adversely affectmaternal and fetal outcomes, but patients with selective pregnancy have better outcomes either in lupus flare or maternal and fetal outcomes compared with those of the nonselective pregnancy.