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目的总结妊娠合并狼疮性肾炎的诊治方法。方法回顾性分析19例妊娠合并狼疮性肾炎患者的临床资料,探讨其诊断与治疗方法。结果综合分析患者的临床表现及免疫学等相关实验室检查结果可以确诊。经糖皮质激素等治疗后,17例患者病情好转出院,1例患者拒绝终止妊娠出院后失访,1例患者自动出院。19例患者共妊娠22例次,其中活产8例次,治疗性流产/引产、死胎共12例次,非医疗原因流产1例次,失访1例次。结论将临床表现和实验室检查结合易做出诊断,可给予糖皮质激素等治疗。狼疮性肾炎并非妊娠的禁忌证,但妊娠期间有可能出现狼疮活动、病情恶化,胎儿的流产、早产、宫内发育迟缓的比例也较高,应适时终止妊娠。
Objective To summarize the diagnosis and treatment of lupus nephritis in pregnancy. Methods The clinical data of 19 patients with pregnancy complicated with lupus nephritis were retrospectively analyzed, and their diagnosis and treatment methods were discussed. The results of a comprehensive analysis of the clinical manifestations of patients and immunology and other related laboratory tests can confirm the results. After treatment with glucocorticoids, 17 patients improved their condition and discharged. One patient refused to terminate pregnancy and were discharged after discharge. One patient was discharged automatically. Twenty-nine patients were pregnant with 22 pregnancies, including 8 live births, 12 therapeutic abortion / induced abortion and stillbirth, 1 non-medical abortion and 1 lost follow-up. Conclusion The combination of clinical manifestations and laboratory tests can be easily diagnosed, may be given glucocorticoid therapy. Lupus nephritis is not a contraindication for pregnancy, but lupus activity may occur during pregnancy, the disease deteriorated, the abortion of the fetus, premature birth, intrauterine growth retardation ratio is higher, timely termination of pregnancy.