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目的 了解系统性红斑狼疮 (SLE)患者妊娠的母婴风险因素。方法 前瞻性地观察1988— 1999年间仁济医院SLE患者妊娠结果 ,将患者分为病情控制 1年以上妊娠组 (A组 ) ,妊娠前 1年内有病情活动组 (B组 )和妊娠期首发病例组 (C组 )。分别观察妊娠期及产后 0 5年内母婴情况并长期随访。结果 71例患者中A组患者 4 9例 ,B组患者 13例 ,C组患者 9例。 1例患者因严重狼疮活动而终止妊娠 ,另 1例患者产下双胎 ,出生活婴 71名。无新生儿狼疮 ,无母婴死亡。妊娠期SLE活动比例A组 9例 (18 4 % )显著低于B组 10例 (76 9% )和C组 9例 (10 0 % ) (P <0 0 1)。A组妊娠期新发肾炎显著少于B、C组 (P <0 0 5 ) ,产后 0 5年肾炎活动显著少于B组 (P <0 0 5 )。A组出生早产儿和低体重儿显著少于B组 (P <0 0 5 )。A组患者中既往有无SLE内脏累及者之间比较 ,妊娠期SLE活动和胎儿异常的比例差异均无显著性 (P >0 0 5 )。结论 SLE患者病情控制 1年以上妊娠 ,母婴安全度显著增高 ,既往有内脏累及不构成特别的风险。妊娠前 1年内有SLE活动者母婴风险显著增大
Objective To understand the maternal and infant risk factors for pregnancy in patients with systemic lupus erythematosus (SLE). Methods Prospectively observed the pregnancy outcome of SLE patients in Renji Hospital from 1988 to 1999. The patients were divided into three groups: control group with more than one year of pregnancy (group A), patients with active disease within one year before pregnancy (group B) and first trimester of pregnancy Group (Group C). Observe the situation of mother and infant during pregnancy and post-nursery 0 05 years and long-term follow-up. Results Among the 71 patients, 49 were in group A, 13 in group B, and 9 in group C. One patient discontinued pregnancy due to severe lupus activity, and the other patient gave birth to twins and 71 live births. No neonatal lupus, no mother-child deaths. The proportion of SLE activity during pregnancy in group A was significantly lower in 9 patients (18.4%) than in group B (10%) and in group C (10%) (P <0.01). Nephritis in group A was significantly less than that in group B and C (P <0.05). Nephritis activity was significantly less in group A than in group B (P0 05). A group of premature birth and low birth weight children were significantly less than the B group (P <0 05). There was no significant difference in the proportion of SLE activity and fetal abnormality between group A and group S with no history of visceral involvement (P> 0.05). Conclusion SLE patients with more than 1 year of pregnancy control pregnancy, maternal and child safety was significantly increased, previous visceral involvement does not constitute a special risk. SLE activity within one year before pregnancy significantly increased the risk of mother-infant