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目的:观察泼尼松联合羟氯喹治疗系统性红斑狼疮(SLE)合并妊娠的临床效果、安全性及对妊娠结局的影响。方法:选择我院收治的SLE活动合并妊娠60例,随机分为观察组和对照组各30例。对照组采用泼尼松治疗,观察组在对照组基础上加用羟氯喹治疗。观察比较两组临床疗效、不良反应发生情况,以及妊娠结局等。结果:两组妊娠初期SLE活动指数(SLEDAI)评分差异不显著(P>0.05),妊娠中期和末期则差异显著(P<0.05)。观察组发生各种不良反应5例,占16.7%;对照组发生6例,占20.0%;两组比较,差异不显著(P>0.05)。观察组足月妊娠、终止妊娠及早产分别为26例(86.7%)、2例(6.7%)和2例(6.7%),对照组为19例(63.3%)、6例(20.0%)、5例(16.7%);两组比较,差异显著(P<0.05)。两组新生儿体质量及1min、5min Apgar评分比较,差异不显著(P>0.05)。结论:泼尼松联合羟氯喹治疗SLE活动合并妊娠效果和妊娠结局较好,且较安全。
Objective: To observe the clinical effect, safety and influence of prednisone and hydroxychloroquine on pregnant women with systemic lupus erythematosus (SLE) complicated with pregnancy. Methods: Sixty cases of SLE combined with pregnancy admitted to our hospital were randomly divided into observation group (30 cases) and control group (30 cases). The control group was treated with prednisone, and the observation group was treated with hydroxychloroquine on the basis of the control group. Observed and compared the clinical efficacy, adverse reactions, and pregnancy outcomes. Results: There was no significant difference in SLE activity index (SLEDAI) score between the two groups at the first trimester of pregnancy (P> 0.05) and the second trimester pregnancy at the second trimester (P <0.05). There were 5 cases of adverse reactions in the observation group, accounting for 16.7%; 6 cases in the control group, accounting for 20.0%. There was no significant difference between the two groups (P> 0.05). In the observation group, there were 26 cases (86.7%), 2 cases (6.7%) and 2 cases (6.7%) of the full-term pregnancy, termination of pregnancy and premature labor respectively. The control group was 19 cases (63.3%), 6 cases (20.0% 5 cases (16.7%); the difference between the two groups was significant (P <0.05). There was no significant difference in body mass, Apgar scores at 1 minute and 5 minutes between two groups (P> 0.05). CONCLUSION: Prednisone and hydroxychloroquine combined with SLE activity have better pregnancy effect and pregnancy outcome and are safer.