切换至 "中华医学电子期刊资源库"

中华产科急救电子杂志 ›› 2018, Vol. 07 ›› Issue (02) : 90 -94. doi: 10.3877/cma.j.issn.2095-3259.2018.02.007

所属专题: 指南与规范 文献 指南共识

专家论坛

妊娠期狼疮危象的早期识别和规范化救治
林维1, 张卫茹1,()   
  1. 1. 410008 长沙,中南大学湘雅医院风湿免疫科
  • 收稿日期:2018-01-05 出版日期:2018-05-18
  • 通信作者: 张卫茹

Early identification and standardized treatment of lupus crisis in pregnancy

Wei Lin1, Weiru Zhang1()   

  • Received:2018-01-05 Published:2018-05-18
  • Corresponding author: Weiru Zhang
引用本文:

林维, 张卫茹. 妊娠期狼疮危象的早期识别和规范化救治[J]. 中华产科急救电子杂志, 2018, 07(02): 90-94.

Wei Lin, Weiru Zhang. Early identification and standardized treatment of lupus crisis in pregnancy[J]. Chinese Journal of Obstetric Emergency(Electronic Edition), 2018, 07(02): 90-94.

系统性红斑狼疮(systemic lupus erythematosus, SLE)是一种好发于育龄期女性的慢性自身免疫性疾病,狼疮危象是指急性的危及生命的重症SLE。妊娠可使SLE患者病情加重,甚至诱发狼疮危象。早期识别和规范化治疗妊娠期狼疮危象,是抢救患者生命的关键。

Systemic lupus erythematosus (SLE) , known as a chronic autoimmune disease, occurs frequently in women of childbearing age. Lupus crisis refers to severe SLE that is acute and life-threatening. Pregnancy may aggravate the condition of pregnant women with SLE and even induce lupus crisis. Early recognition and standardized treatment are the keys to rescue the lupus crisis pregnancies' lives.

表1 妊娠与狼疮活动的临床特点及实验室特征[12]
表2 子痫前期和狼疮肾炎活动的鉴别
[1]
中华医学会风湿病学分会. 系统性红斑狼疮诊治指南[J]. modern pratical medicine, 2003, 15(12): 764-769.
[2]
Petri M, Orbai AM, Alarcón GS, et al. Derivation and validation of the Systemic Lupus International Collaborating Clinics classification criteria for systemic lupus erythematosus[J]. Arthritis Rheum, 2012, 64(8): 2677-2686.
[3]
Tedeschi SK, Johnson SR, Boumpas D, et aL. Developing and Refining New Candidate Criteria for Systemic Lupus Erythematosus Classification: An International Collaboration [J]. Arthritis Care Res (Hoboken), 2018, 70(4):571-581.
[4]
郭松,张建平. 妊娠合并系统性红斑狼疮活动期的管理[J/CD]. 中国产科急救电子杂志,2017, 6(1): 14-18.
[5]
杜红卫,马大庆,吴红华. 13例狼疮危象临床分析[J]. 临床医学,2008, 28(6): 13-14.
[6]
翁敏,张虹,李俊. 狼疮肾炎伴狼疮危象37例临床分析[J]. 昆明医学院学报,2001, 22(2): 18-20.
[7]
Ruiz-Irastorza G, Lima F, Alves J, et al. Increased rate of lupus flare during pregnancy and the puerperium: a prospective study of 78 pregnancies[J]. Br J Rheumatol, 1996, 35(2): 133-138.
[8]
Mackillop LH,Germain SJ, Nelson-Piercy C, et al. Systemic lupus erythematosus[J]. BMJ, 2007, 335(7626): 933-936.
[9]
Petri M. The Hopkins Lupus Pregnancy Center: ten key issues in management[J]. Rheum Dis Clin North Am, 2007, 33(2): 227-235.
[10]
Jara LJ, Medina G, Cruz-Dominguez P, et al. Risk factors of systemic lupus erythematosus flares during pregnancy[J]. Immunol Res, 2014, 60(2-3): 184-192.
[11]
中华医学会风湿病学分会. 系统性红斑狼疮诊断及治疗指南[J]. 中华风湿病学杂志,2010, 14(5): 342-346.
[12]
Lateef A, Petri M. Systemic lupus erythematosus and pregnancy[J]. Rheum Dis Clin North Am, 2017, 43(2): 215-226.
[13]
Ruiz-Irastorza G, Khamashta MA, Gordon C, et al. Measuring systemic lupus erythematosus activity during pregnancy: validation of the lupus activity index in pregnancy scale [J]. Arthritis Rheum, 2004, 51(1): 78-82.
[14]
Vymetal J, Skacelova M, Smrzova A, et al. Emergency situations in rheumatology with a focus on systemic autoimmune diseases[J]. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub, 2016, 160(1): 20-29.
[15]
中国系统性红斑狼疮研究协作组专家组,国家风湿病数据中心. 中国系统性红斑狼疮患者围产期管理建议[J]. 中华医学杂志,2015, 95(14): 1056-1060.
[16]
Wei Q, Ouyang Y, Zeng W, et al. Pregnancy complicating systemic lupus erythematosus: a series of 86 cases[J]. Arch Gynecol Obstet, 2011, 284(5): 1067-1071.
[17]
Andreoli L, Bertsias GK, Agmon-Levin N, et al. EULAR recommendations for women′s health and the management of family planning, assisted reproduction, pregnancy and menopause in patients with systemic lupus erythematosus and/or antiphospholipid syndrome[J]. Ann Rheum Dis, 2017, 76(3): 476-485.
[18]
李常虹,刘湘源. 妊娠期及哺乳期使用抗风湿病药物的最新英国推荐指南.中华风湿病学杂志[J]. 2016, 20(5): 358-360.
[19]
陈曼绮,张建平. 妊娠合并狼疮危象诊疗[J/CD]. 中华产科急救电子杂志,2016, 5(2): 80-85.
[1] 杨皓媛, 龚杰, 邹青伟, 阮航. 哮喘孕妇的母婴不良妊娠结局研究现状[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(05): 522-529.
[2] 陈甜甜, 王晓东, 余海燕. 双胎妊娠合并Gitelman综合征孕妇的妊娠结局及文献复习[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(05): 559-568.
[3] 居晓庆, 金蕴洁, 王晓燕. 剖宫产术后瘢痕子宫患者再次妊娠阴道分娩发生子宫破裂的影响因素分析[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(05): 575-581.
[4] 顾娟, 孙擎擎, 胡方方, 曹义娟, 祁玉娟. 子宫内膜容受性检测改善胚胎反复种植失败患者妊娠结局的临床应用[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(05): 582-587.
[5] 王蓓蓓, 董启秀, 郗红燕, 于庆云, 张丽君, 式光. 早孕期孕妇药物流产失败的影响因素分析与构建相关预测模型及其对药物流产成功的预测价值[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(05): 588-594.
[6] 陈絮, 詹玉茹, 王纯华. 孕妇ABO血型联合甲状腺功能检测对预测妊娠期糖尿病的临床价值[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(05): 604-610.
[7] 周梦玲, 薛志伟, 周淑. 妊娠合并子宫肌瘤的孕期变化及其与不良妊娠结局的关系[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(05): 611-615.
[8] 娄丽丽, 刘瀚旻. 儿童狼疮性肾炎相关肾小管间质损伤的研究现状[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(04): 373-378.
[9] 冉晨曦, 沈如飞, 廖明钰, 廖倩, 周玲, 张玉玲, 隆敏. 垂体瘤孕妇的诊治与围分娩期管理[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(04): 487-491.
[10] 胡金科, 钟文. 妊娠期输尿管结石的处理与转归[J]. 中华腔镜泌尿外科杂志(电子版), 2023, 17(04): 377-381.
[11] 王跃, 唐敏, 李鹏超, 吕强. 妊娠期膀胱副神经节瘤伴严重出血一例报告[J]. 中华腔镜泌尿外科杂志(电子版), 2023, 17(04): 410-411.
[12] 杨聚荣. 透析患者妊娠的管理[J]. 中华肾病研究电子杂志, 2023, 12(05): 300-300.
[13] 张郁妍, 胡滨, 张伟红, 徐楣, 朱慧, 羊馨玥, 刘海玲. 妊娠中期心血管超声参数与肝功能的相关性及对不良妊娠结局的预测价值[J]. 中华消化病与影像杂志(电子版), 2023, 13(06): 499-504.
[14] 王欣, 刘琳, 闻哲嘉, 刘春玲, 张弘, 吕芳. 妊娠前应激暴露对小鼠后续妊娠的影响[J]. 中华临床医师杂志(电子版), 2023, 17(04): 431-437.
[15] 邹艳丽, 栾文杰, 王淑娟, 刘亚琴, 初桂芝, 李松洋, 王好玲, 张锦婷, 姜鑫, 栾泽东. 早孕期胎儿右位主动脉弓的产前超声诊断学特征[J]. 中华诊断学电子杂志, 2023, 11(04): 227-232.
阅读次数
全文


摘要