【摘要】 目的探讨免疫指标对妊娠合并系统性红斑狼疮(SLE)患者妊娠结局的指导意义。方法选取2003年1月—2015年12月到首都医科大学附属北京世纪坛医院就诊的妊娠合并SLE患者20例,均进行规律孕期监测和治疗。选取抗核抗体、血清补体水平及红细胞沉降率为免疫指标,比较不同免疫情况患者的妊娠结局和妊娠期并发症发生率。结果 20例患者中,抗核抗体阳性13例,血清补体水平下降5例,红细胞沉降率加快5例。抗核抗体阳性患者的早产例数高于抗核抗体阴性患者,平均孕周、平均新生儿体质量低于抗核抗体阴性患者,差异有统计学意义(P<0.05);而死胎例数与抗核抗体阴性患者比较,差异无统计学意义(P>0.05)。血清补体水平下降患者的早产例数高于血清补体水平正常患者,平均孕周、平均新生儿体质量低于血清补体水平正常患者,差异有统计学意义(P<0.05);而死胎例数与血清补体水平正常患者比较,差异无统计学意义(P>0.05)。红细胞沉降率加快患者的早产例数、死胎例数高于红细胞沉降率正常患者,平均孕周、平均新生儿体质量低于红细胞沉降率正常患者,差异有统计学意义(P<0.05)。不同抗核抗体滴度、血清补体水平、红细胞沉降率患者的并发症发生率比较,差异无统计学意义(P>0.05)。结论妊娠合并SLE患者的不良妊娠结局发生风险较高,不同免疫情况患者间存在差异,推测抗核抗体阳性、血清补体水平下降、红细胞沉降率加快预示着不良妊娠结局的发生。更多还原

【Abstract】 Objective To investigate the significance of immune indexes in predicting pregnancy outcomes of pregnant patients with systemic lupus erythematosus( SLE). Methods From January 2003 to December 2015,we enrolled 20 pregnant SLE patients who received treatment in Beijing Shijitan Hospital Affiliated to Capital Medical University. The patients all received regular examination and treatment during pregnancy. Antinuclear antibodies, serum complement level and erythrocyte sedimentation rate were selected as immune indexes. Pregnancy outcomes and the incidence of pregnancy complications were compared among patients with different positive conditions of immune indexes. Results Among the 20 patients,there were 13 patients with positive antinuclear antibodies, 5 patients whose serum complement level decreased, and 5 patients whose erythrocyte sedimentation rate increased. Compared with patients who had negative antinuclear antibodies,patients with positive antinuclear antibodies had more cases of early delivery,less average gestational weeks,and lighter body weight of newborns( P< 0. 05); the number of cases of stillbirth was not significantly different( P > 0. 05). Compared with patients with normal serum complement level,patients whose serum complement level decreased had more cases of early delivery,less average gestational weeks,and lighter body weight of newborns( P < 0. 05); the number of cases of stillbirth was not significantly different( P >0. 05). Compared with patients with normal erythrocyte sedimentation rate, patients whose erythrocyte sedimentation rate increased had more cases of premature delivery and stillbirth,less gestational weeks and lighter average body weight of newborns( P < 0. 05). Patients with different titers of antinuclear antibodies,serum complement levels,and erythrocyte sedimentation rate were not significantly different in the incidence of complications( P > 0. 05). Conclusion Pregnant patients with SLE have higher incidence of unfavorable pregnancy outcomes,and differences exist among patients with different conditions of immune indexes. Positive antinuclear antibodies,decrease in serum complement level,and acceleration of erythrocyte sedimentation rate may predict unfavorable pregnancy outcomes.更多还原