【摘要】：目的：探討羥氯喹對系統(tǒng)性紅斑狼瘡合并妊娠患者的疾病活動、妊娠結局和胎兒結局的影響。 方法：回顧性分析湘雅醫(yī)院2003年8月至2014年3月收治的83例SLE選擇性妊娠患者的臨床資料。根據孕期是否使用HCQ,分為HCQ組和非HCQ組,比較兩組孕期SLE活動率、妊娠結局、胎兒結局,并對子代進行隨訪,隨訪內容包括生長發(fā)育,是否有新生兒狼瘡及自身抗體檢測。 結果：HCQ組43例妊娠患者中4例發(fā)生SLE活動,19例有狼瘡腎炎病史的患者中2例腎病復發(fā)；妊娠丟失7例,早產6例,胎膜早破7例,羊水過少5例；新生兒先天異常1例,宮內窘迫3例,生長受限2例,低體重兒4例。非HCQ組40例患者中13例發(fā)生SLE活動,14例有狼瘡腎炎病史的患者中6例腎病復發(fā)；妊娠丟失8例,早產8例,胎膜早破7例,羊水過少3例；宮內窘迫1例,生長受限1例,低體重兒6例。HCQ組SLE活動率和狼瘡腎炎復發(fā)率顯著低于非HCQ組(P=0.013和P=0.042)。兩組妊娠結局、胎兒結局無顯著差異(P0.05)。HCQ組36例子代,1例發(fā)生新生兒狼瘡,6例子代出現(xiàn)抗核抗體滴度升高,1例因腦發(fā)育不全死亡。非HCQ組32例子代,1例發(fā)生新生兒狼瘡,5例子代出現(xiàn)抗核抗體滴度升高。 結論：SLE患者妊娠期間使用HCQ可降低孕期SLE活動率和LN復發(fā)率,不增加不良妊娠結局、不良胎兒結局的發(fā)生風險。
[Abstract]:Objective: To investigate the effect of hydroxychloroquine on disease activity, pregnancy outcome and fetal outcome in pregnant women with systemic lupus erythematosus.
Methods: the clinical data of 83 patients with SLE selective pregnancy treated in Xiangya Hospital from August 2003 to March 2014 were retrospectively analyzed. According to whether HCQ was used in pregnancy, it was divided into HCQ group and non HCQ group. The SLE activity rate, pregnancy outcome, fetal outcome were compared in the two groups of pregnancy, and the follow-up was carried out for the offspring, including the growth and development, whether there were newborns. Lupus and autoantibody test.
Results: in group HCQ, 4 of 43 cases of pregnancy had SLE activity, 19 had recurrent nephrosis in the history of lupus nephritis, 7 cases of pregnancy loss, 6 premature delivery, 7 premature rupture of membranes, 5 amniotic fluid, 3 neonates with congenital abnormality, 3 cases of intrauterine embarrassment, 2 growth restriction, 4 cases of low weight infants. SLE activity occurred in 19 cases of non HCQ group 40 patients. In the patients with the history of lupus nephritis, 6 patients had recurrence of kidney disease, 8 cases of pregnancy loss, 8 cases of premature birth, 7 cases of premature rupture of membranes, 3 cases of oligohydramnios, 1 cases of intrauterine distress, 1 cases of growth restriction, and 6 cases of.HCQ group of low weight infants and the recurrence rate of lupus nephritis were significantly lower than those in non HCQ group (P=0.013 and P=0.042). Two groups of pregnancy outcome, and no significant difference in fetal outcome were found. (P0.05) group.HCQ 36 example generation, 1 cases of neonatal lupus, 6 example generation of anti nuclear antibody titer, 1 cases of brain dysplasia death. Non HCQ group 32 example, 1 cases of neonatal lupus, 5 example of the generation of antinuclear antibody titer.
Conclusion: the use of HCQ during pregnancy can reduce the SLE activity rate and LN recurrence rate in SLE patients without increasing the risk of adverse pregnancy outcomes and the risk of adverse fetal outcomes.
【學位授予單位】：中南大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R714.25

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