羟氯喹在SLE合并妊娠患者中应用的疗效和安全性评估

发布时间：2018-07-25 18:23

【摘要】：目的：探讨羟氯喹对系统性红斑狼疮合并妊娠患者的疾病活动、妊娠结局和胎儿结局的影响。方法：回顾性分析湘雅医院2003年8月至2014年3月收治的83例SLE选择性妊娠患者的临床资料。根据孕期是否使用HCQ,分为HCQ组和非HCQ组,比较两组孕期SLE活动率、妊娠结局、胎儿结局,并对子代进行随访,随访内容包括生长发育,是否有新生儿狼疮及自身抗体检测。结果：HCQ组43例妊娠患者中4例发生SLE活动,19例有狼疮肾炎病史的患者中2例肾病复发；妊娠丢失7例,早产6例,胎膜早破7例,羊水过少5例；新生儿先天异常1例,宫内窘迫3例,生长受限2例,低体重儿4例。非HCQ组40例患者中13例发生SLE活动,14例有狼疮肾炎病史的患者中6例肾病复发；妊娠丢失8例,早产8例,胎膜早破7例,羊水过少3例；宫内窘迫1例,生长受限1例,低体重儿6例。HCQ组SLE活动率和狼疮肾炎复发率显著低于非HCQ组(P=0.013和P=0.042)。两组妊娠结局、胎儿结局无显著差异(P0.05)。HCQ组36例子代,1例发生新生儿狼疮,6例子代出现抗核抗体滴度升高,1例因脑发育不全死亡。非HCQ组32例子代,1例发生新生儿狼疮,5例子代出现抗核抗体滴度升高。结论：SLE患者妊娠期间使用HCQ可降低孕期SLE活动率和LN复发率,不增加不良妊娠结局、不良胎儿结局的发生风险。
[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.
【学位授予单位】：中南大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R714.25

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