摘要
目的分析妊娠合并系统性红斑狼疮并发重度血小板减少患者的妊娠结局,探讨妊娠与红斑狼疮之间的相互影响。方法选取2010年4月-2018年10月期间郑州大学第二附属医院收治的46例妊娠合并系统性红斑狼疮患者,对其临床资料进行回顾性分析。根据是否并发重度血小板减少分组,即血小板减少组(n=17)和血小板正常组(n=29),对两组围生结局进行对比和分析。结果血小板减少组胎死宫内率、狼疮活动指数均高于血小板正常组(均P <0.05);两组子痫前期、死亡率、早产儿、低体重儿对比无显著差异(P> 0.05);血小板减少组患者,其血小板值与狼疮活动指数呈明显负相关(P <0.05)。结论妊娠合并系统性红斑狼疮并发重度血小板减少患者,血小板值越低,狼疮活动指数越高,可增加胎死宫内发生率,需要做好监测和孕前指导,对狼疮活动情况进行监测,切实保证母婴安全。
Objective To analyze the pregnancy outcome of pregnancy complicated with systemic lupus erythematosus complicated with severe thrombocytopenia, and to explore the mutual influence between pregnancy and lupus erythematosus.Methods 46 cases of pregnancy complicated with systemic lupus erythematosus admitted to the Second Affiliated Hospital of Zhengzhou University from April 2010 to October 2018 were selected and their clinical data were analyzed retrospectively.According to whether severe thrombocytopenia is complicated or not, namely thrombocytopenia group(n=17) and normal platelet group(n=29), the perinatal outcomes of the two groups were compared and analyzed. Results The intrauterine fetal death rate and lupus activity index in thrombocytopenia group were higher than those in normal platelet group(all P < 0.05).There was no significant difference in preeclampsia, mortality, premature infants and low birth weight infants between the two groups(P > 0.05). The platelet value of patients in thrombocytopenia group was significantly negatively correlated with lupus activity index(P < 0.05). Conclusion The lower the platelet value is, the higher the lupus activity index is in pregnancy complicated with systemic lupus erythematosus complicated with severe thrombocytopenia, which can increase the intrauterine incidence of fetal death. Monitoring and pre-pregnancy guidance are needed to monitor lupus activity and ensure the safety of mother and infant.
引文
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