留言板

尊敬的读者、作者、审稿人, 关于本刊的投稿、审稿、编辑和出版的任何问题, 您可以本页添加留言。我们将尽快给您答复。谢谢您的支持!

姓名
邮箱
手机号码
标题
留言内容
验证码

妊娠期系统性红斑狼疮综合管理

崔阳 张晓

崔阳, 张晓. 妊娠期系统性红斑狼疮综合管理[J]. 协和医学杂志, 2020, 11(3): 270-275. doi: 10.3969/j.issn.1674-9081.20200026
引用本文: 崔阳, 张晓. 妊娠期系统性红斑狼疮综合管理[J]. 协和医学杂志, 2020, 11(3): 270-275. doi: 10.3969/j.issn.1674-9081.20200026
Yang CUI, Xiao ZHANG. Comprehensive Management of Systemic Lupus Erythematosus During Pregnancy[J]. Medical Journal of Peking Union Medical College Hospital, 2020, 11(3): 270-275. doi: 10.3969/j.issn.1674-9081.20200026
Citation: Yang CUI, Xiao ZHANG. Comprehensive Management of Systemic Lupus Erythematosus During Pregnancy[J]. Medical Journal of Peking Union Medical College Hospital, 2020, 11(3): 270-275. doi: 10.3969/j.issn.1674-9081.20200026

妊娠期系统性红斑狼疮综合管理

doi: 10.3969/j.issn.1674-9081.20200026
详细信息
    通讯作者:

    张晓  电话:020-83824249,E-mail:13922255387@163.com

  • 中图分类号: R593.24;R715

Comprehensive Management of Systemic Lupus Erythematosus During Pregnancy

More Information
  • 摘要: 系统性红斑狼疮(systemic lupus erythematosus, SLE)是一种育龄期,尤其是20~40岁女性高发的疾病。此年龄段患者多有怀孕生子的需求,但SLE患者合并妊娠时不但疾病本身可能反复或加重,不良妊娠风险亦显著增加,因此做好SLE患者妊娠期综合管理极其重要。本文主要阐述SLE与妊娠的相互影响及妊娠期SLE患者的综合管理,以期指导临床更好地认识该问题,从而改善SLE患者的妊娠结局。
    利益冲突  无
  • [1] Park MC, Park YB, Jung SY, et al. Risk of ovarian failure and pregnancy outcome in patients with lupus nephritis treated with intravenous cyclophosphamide pulse therapy[J]. Lupus, 2004,13:569-574. doi:  10.1191/0961203304lu1063oa
    [2] Jakobsen IM, Helmig RB, Stengaard-Pedersen K. Maternal and foetal outcomes in pregnant systemic lupus erythematosus patients:an incident cohort from a stable referral population followed during 1990-2010[J]. Scand J Rheumatol, 2015,44:377-384. doi:  10.3109/03009742.2015.1013982
    [3] Palma Dos Reis CR, Cardoso G, Carvalho C, et al. Prediction of Adverse Pregnancy Outcomes in Women with Systemic Lupus Erythematosus[J]. Clin Rev Allergy Immunol, 2019.doi:10.1007/s12016-019-08762-9.[Epub ahead of print].
    [4] Sammaritano LR. Management of Systemic Lupus Erythematosus During Pregnancy[J]. Annu Rev Med, 2017,68:271-285. doi:  10.1146/annurev-med-042915-102658
    [5] Tedeschi SK, Massarotti E, Guan H, et al. Specific systemic lupus erythematosus disease manifestations in the six months prior to conception are associated with similar disease manifestations during pregnancy[J]. Lupus, 2015,24:1283-1292. doi:  10.1177/0961203315586455
    [6] Kattah AG, Garovic VD. Pregnancy and Lupus Nephritis[J]. Semin Nephrol, 2015,35:487-499. doi:  10.1016/j.semnephrol.2015.08.010
    [7] Cozzani E, Drosera M, Gasparini G, et al. Serology of Lupus Erythematosus:Correlation between Immunopathologi-cal Features and Clinical Aspects[J]. Autoimmune Dis, 2014,2014:321359. https://www.hindawi.com/journals/ad/2014/321359/
    [8] Teng YKO, Bredewold EOW, Rabelink TJ, et al. An evidence-based approach to pre-pregnancy counselling for pa-tients with systemic lupus erythematosus[J].Rheumatology, 2018,57:1707-1720. doi:  10.1093/rheumatology/kex374
    [9] Brito-Zerón P, Izmirly PM, Ramos-Casals M, et al. The clinical spectrum of autoimmune congenital heart block[J]. Nat Rev Rheumatol, 2015,11:301-312. doi:  10.1038/nrrheum.2015.29
    [10] Kan N, Silverman ED, Kingdom J, et al. Serial echocardiography for immune-mediated heart disease in the fetus:results of a risk-based prospective surveillance strategy[J]. Prenat Diagn, 2017,37:375-382. doi:  10.1002/pd.5021
    [11] Maynard S, Guerrier G, Duffy M. Pregnancy in Women With Systemic Lupus and Lupus Nephritis[J]. Adv Chronic Kidney Dis, 2019,26:330-337. doi:  10.1053/j.ackd.2019.08.013
    [12] Nahal SK, Selmi C, Gershwin ME. Safety issues and recommendations for successful pregnancy outcome in systemic lupus erythematosus[J]. J Autoimmun, 2018,93:16-23. doi:  10.1016/j.jaut.2018.07.016
    [13] Lazzaroni MG, Dall Ara F, Fredi M, et al. A comprehensive review of the clinical approach to pregnancy and systemic lupus erythematosus[J]. J Autoimmun, 2016,74:106-117. doi:  10.1016/j.jaut.2016.06.016
    [14] Petri M. Pregnancy and Systemic Lupus Erythematosus[J]. Best Pract Res Clin Obstet Gynaecol, 2019,19:30133-30136. https://www.sciencedirect.com/science/article/pii/S1521693419301336
    [15] Espinosa G, Cervera R. Current treatment of antiphos-pholipid syndrome:lights and shadows[J]. Nat Rev Rheumatol, 2015,11:586-596. doi:  10.1038/nrrheum.2015.88
    [16] Hwang J, Shin S, Kim Y, et al. Epidemiology of Antiphospholipid Syndrome in Korea:a Nationwide Population-based Study[J]. J Korean Med Sci, 2020,35:e35. doi:  10.3346/jkms.2020.35.e35
    [17] Limper M, de Leeuw K, Lely AT, et al. Diagnosing and treating antiphospholipid syndrome:a consensus paper[J]. Neth J Med, 2019,77:98-108.
    [18] Lazzaroni MG, Dall Ara F, Fredi M, et al. A comprehensive review of the clinical approach to pregnancy and systemic lupus erythematosus[J]. J Autoimmun, 2016,74:106-117. doi:  10.1016/j.jaut.2016.06.016
    [19] Cavazzana I, Andreoli L, Limper M, et al. Update on Antiphospholipid Syndrome:Ten Topics in 2017[J]. Curr Rheumatol Rep, 2018,20:15. doi:  10.1007/s11926-018-0718-4
    [20] Andreoli L, Fredi M, Nalli C, et al. Pregnancy implications for systemic lupus erythematosus and the antiphospholipid syndrome[J]. J Autoimmun, 2012,38:J197-J208. doi:  10.1016/j.jaut.2011.11.010
    [21] Ruiz-Irastorza G, Crowther M, Branch W, et al. Antiphospholipid syndrome[J]. Lancet, 2010,376:1498-1509. doi:  10.1016/S0140-6736(10)60709-X
    [22] Buyon JP, Kim MY, Guerra MM, et al. Predictors of Pregnancy Outcomes in Patients With Lupus[J]. Ann Intern Med, 2015,163:153. doi:  10.7326/M14-2235
    [23] Liu T, Gu J, Wan L, et al. "Non-criteria" antiphospholipid antibodies add value to antiphospholipid syndrome diagnoses in a large Chinese cohort[J].Arthritis Res Ther, 2020,22:33. doi:  10.1186/s13075-020-2131-4
    [24] Marchetti T, Ribi C, Perneger T, et al. Prevalence, persistence and clinical correlations of classic and novel antiphospholipid antibodies in systemic lupus erythematosus[J].Rheumatology, 2018,57:1350-1357. doi:  10.1093/rheumatology/key095
    [25] Bertin D, Beziane A, Resseguier N, et al. Interest of IgG and IgM antiprothrombin autoantibodies in the exploration of antiphospholipid syndrome:a 5-year retrospective study[J]. Rheumatology (Oxford), 2019, pii:z453. doi:  10.1093/rheumatology/kez453/5599884
    [26] Tektonidou MG, Andreoli L, Limper M, et al. EULAR recommendations for the management of antiphospholipid syndrome in adults[J]. Ann Rheum Dis, 2019,78:1296-1304. doi:  10.1136/annrheumdis-2019-215213
    [27] 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, 2015,95:1056-1060. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=zhyx201514005
    [28] Martínez López JA, García Vivar ML, Cáliz R, et al. Recomendaciones sobre actuaciones a seguir durante la edad fértil, el embarazo, posparto y lactancia en pacientes con enfermedades reumáticas inflamatorias y autoinmunes[J]. Reumatología Clínica, 2017,13:264-281.
    [29] Sammaritano L, Bermas B, Chambers C, et al. 2020 American College of Rheumatology Guideline for the Management of Reproductive Health in Rheumatic and Musculoskeletal Diseases.[J]. Arthritis Care Res, 2020,72:461-488. doi:  10.1002/acr.24130
    [30] Cyprian F, Lefkou E, Varoudi K, et al. Immunomodulatory Effects of Vitamin D in Pregnancy and Beyond[J]. Front Immunol, 2019,10:2739. doi:  10.3389/fimmu.2019.02739
    [31] Flint J, Panchal S, Hurrell A, et al. BSR and BHPR guideline on prescribing drugs in pregnancy and breastfeeding-Part I:standard and biologic disease modifying anti-rheumatic drugs and corticosteroids[J]. Rheumatology(Oxford), 2016,55:1693-1697. doi:  10.1093/rheumatology/kev404
    [32] Marder W. Update on pregnancy complications in systemic lupus erythematosus[J]. Curr Opin Rheumatol, 2019,31:650-658. doi:  10.1097/BOR.0000000000000651
    [33] Götestam Skorpen C, Hoeltzenbein M, Tincani A, et al. The EULAR points to consider for use of antirheumatic drugs before pregnancy, and during pregnancy and lactation[J]. Ann Rheum Dis, 2016,75:795-810. doi:  10.1136/annrheumdis-2015-208840
    [34] Liu X, Qiu Y, Yu ED, et al. Comparison of therapeutic interventions for recurrent pregnancy loss in association with antiphospholipid syndrome:A systematic review and network meta-analysis[J]. Am J Reprod Immunol, 2019,83:e13219. doi:  10.1111/aji.13219
    [35] Sciascia S, Hunt BJ, Talavera-Garcia E, et al. The impact of hydroxychloroquine treatment on pregnancy outcome in women with antiphospholipid antibodies[J].Am J Obstet Gynecol, 2016,214:271-273. https://www.ncbi.nlm.nih.gov/pubmed/26429521
    [36] Mekinian A, Lazzaroni MG, Kuzenko A, et al. The efficacy of hydroxychloroquine for obstetrical outcome in anti-phospholipid syndrome:Data from a European multicenter retrospective study[J]. Autoimmun Rev, 2015,14:498-502. doi:  10.1016/j.autrev.2015.01.012
    [37] Bramham K, Thomas M, Nelson-Piercy C, et al. First-trimester low-dose prednisolone in refractory antiphospholipid antibody-related pregnancy loss[J]. Blood, 2011,117:6948-6951. doi:  10.1182/blood-2011-02-339234
    [38] Svenungsson E, Antovic A. The Antiphospholipid Syndrome-often overlooked cause of vascular occlusions?[J]. J Intern Med, 2020,287:349-372. doi:  10.1111/joim.13022
    [39] Sammaritano LR, Bermas BL. Management of pregnancy and lactation[J]. Best Pract Res Clin Rheumatol, 2018,32:750-766. doi:  10.1016/j.berh.2019.03.007
    [40] Götestam Skorpen C, Hoeltzenbein M, Tincani A, et al. The EULAR points to consider for use of antirheumatic drugs before pregnancy, and during pregnancy and lactation[J]. Ann Rheum Dis, 2016,75:795-810. doi:  10.1136/annrheumdis-2015-208840
  • 加载中
计量
  • 文章访问数:  334
  • HTML全文浏览量:  31
  • PDF下载量:  139
  • 被引次数: 0
出版历程
  • 收稿日期:  2020-02-05
  • 刊出日期:  2020-05-30

目录

    /

    返回文章
    返回

    【温馨提醒】近日,《协和医学杂志》编辑部接到作者反映,有多名不法人员冒充期刊编辑发送见刊通知,鼓动作者添加微信,从而骗取版面费的行为。特提醒您,本刊与作者联系的方式均为邮件通知或电话,稿件进度通知邮箱为:mjpumch@126.com,编辑部电话为:010-69154261,请提高警惕,谨防上当受骗!如有任何疑问,请致电编辑部核实。谢谢!