黄晓涓

系统性红斑狼疮合并妊娠高血压疾病的临床治疗方法及疗效

黄晓涓

目的 探讨系统性红斑狼疮（SLE）合并妊娠高血压（PIH）患者的临床治疗方法及疗效。方法 选取1999年1月至2015年12月惠州市第三人民医院收治的30例SLE合并PIH患者作为研究对象，按照随机数字表法将其分为试验组和对照组，各15例。对照组患者给予解痉、降压、镇静等常规对症治疗，试验组患者在对照组基础上采用激素进行治疗，比较两组患者的临床疗效及母婴结局。结果 试验组患者治疗的总有效率明显高于对照组，剖宫产率、产后出血率、术口愈合不良率、胎儿窘迫及新生儿窒息率均明显低于对照组，差异均有统计学意义（均P＜0.05）。结论 在解痉降压适当镇静、有指征有条件扩容利尿基础上采用激素治疗SLE合并PIH，可明显提高临床疗效，改善母婴结局，减少狼疮危像发生，具有重要临床意义。

妊娠高血压；系统性红斑狼疮；激素；临床疗效；母婴结局

【Abstract】Objective To investigate the clinical treatment and efficacy of systemic lupus erythematosus （SLE）complicated with hypertensive disorder complicating pregnancy （PIH）.Methods From January 1999 to December 2015，30 cases of SLE complicated with PIH in third people's Hospital of Huizhou were selected as the research object.According to the random number table method，it was divided into the experimental group and the control group，each of 15 cases.Control group，antispasmodic，antihypertensive，sedative and other conventional symptomatic treatment，the experimental group of patients in the control group based on the use of hormone therapy，compared two groups of patients with clinical curative effect and maternal and neonatal outcomes.Results Treatment of patients in the experimental group the total efficiency was significantly higher than that of control group，cesarean section， postpartumhemorrhage rate，incision healing rate，fetal distress and the rate of neonatal asphyxia were significantly lower than those in the control group，the differences were statistically significant（P＜0.05）.Conclusion In spasmolysis，stepdown，appropriate sedation，indications have used conditions of expansion on the basis of diuresis hormone treatment of SLE associated with PIH，significantly improved clinical efficacy，improve maternal and neonatal outcomes，reduce lupus crisis like the occurrence， has important clinical significance.

【Key words】Pregnancy induced hypertension disease；Systemic lupus erythematosus；Hormone；Clinical efficac；Maternal and neonatal outcomes

系统性红斑狼疮（SLE）是一种损伤累及全身各系统的慢性自身免疫性疾病，好发于年轻女性，国外报道孕妇发病率为1/5000［1］，SLE患者预后不良，在妊娠期间极易发病及加重，常合并妊娠高血压（PIH）疾病。妊娠期间使用激素可有效缓解病情，但相当一部分SLE患者因对自身疾病认识不足，或因经济、教育、文化等原因未采取治疗措施，易导致PIH发生，加重病情。PIH是产科常见病、多发病之一，严重危害母婴健康安全，常发生于妊娠20周后，病理变化为全身小血管痉挛，内皮细胞损伤及局部组织缺血，会导致全身各系统各器官损伤。……