Lupus nephropathy and pregnancy. Report of 104 cases in 36 patients.
Lupus nephropathy and pregnancy. Report of 104 cases in 36 patients.
复制标题
狼疮肾病和妊娠。
DOI：
10.1001/archinte.1982.00340170127021
复制
发表时间：
1982
影响因子：
--
通讯作者：
J. Bach
中科院分区：
文献类型：
--
作者：
P. Jungers;M. Dougados;C. Pélissier;F. Kuttenn;F. Tron;P. Lesavre;J. Bach
狼疮肾病对妊娠结局以及妊娠对肾脏受累过程的相互影响通过过去 20 年来观察到的 36 名狼疮肾病患者的 106 次妊娠进行回顾性研究。在系统性红斑狼疮 (SLE) 临床发病前开始的 64 例妊娠中，经人工流产校正后的活产总发生率为 54 例 (84%)，在 SLE 发病后开始的 23 例妊娠中，活产率为 20 例 (87%)，而在妊娠期间或妊娠后首次出现 SLE 的 7 例中，活产率仅为 4 例 (57%)。 26 例妊娠中，有 12 例 (46%) 在 SLE 临床发作之前出现疾病活动复发或恶化，妊娠期间比产后更为常见，其中 2 例 (8%) 出现肾功能不可逆恶化；在受孕时 SLE 处于临床活动期的 15 例患者中，有 11 例 (66%) 观察到狼疮疾病的临床恶化，而在受孕前至少 5 个月 SLE 肾炎处于稳定临床缓解状态的 11 例中，只有 1 例 (9%) 观察到狼疮疾病的临床恶化。数据表明，即使是更严重的狼疮性肾炎，如果在持续、完全的临床缓解后开始妊娠，也有望获得成功的妊娠结果。
The reciprocal influence of lupus nephropathy on the outcome of pregnancy and of pregnancy on the course of renal involvement was studied retrospectively in a series of 106 pregnancies observed during the past two decades in 36 patients with lupus nephropathy. The overall incidence of live births, corrected for induced abortions, was 54 (84%) in 64 pregnancies that began before clinical onset of systemic lupus erythematosus (SLE), 20 (87%) in 23 pregnancies that began after onset of SLE, and only four (57%) in seven cases where SLE was first manifested during or after gestation. Relapse or exacerbation of disease activity occurred in 12 (46%) of 26 pregnancies antedated by clinical onset of SLE, more frequently during gestation than post partum, with two cases (8%) of irreversible deterioration of renal function; clinical exacerbation of lupus disease was observed in 11 (66%) of 15 cases where SLE was clinically active at the time of conception, and in only one (9%) of 11 cases where SLE nephritis was in stable clinical remission for at least five months before conception. The data indicate that successful outcome of pregnancy may be expected even in the more severe forms of lupus nephritis if gestation begins after a sustained, complete clinical remission.