Ann Rheum Dis:宫内羟氯喹暴露对皮肤性新生儿红斑狼疮的影响

2022-06-09 xiangting MedSci原创

HCQ暴露与患cNL的风险降低相关。在cNL病例中,HCQ暴露婴儿的皮疹出现较晚。

抗Ro±抗La抗体暴露婴儿中5%-16%可能发生皮肤性新生儿狼疮(cNL)。数据表明宫内接触羟氯喹(HCQ)可能会预防心脏NL。这项研究目的是评估宫内HCQ暴露是否会降低cNL的风险和/或延迟发病。

这是一项对122例cNL病例和434例对照进行的多中心病例对照研究。这些对照婴儿的母亲患风湿性疾病,并记录了妊娠期母体存在抗Ro±抗La抗体,用药情况和儿童结局明确。不论母亲的诊断如何,对262例cNL病例进行了二次分析,以确定HCQ是否延迟了cNL发病的时间。

20例(16%)cNL病例暴露于HCQ,而对照组中有146例(34%)暴露于HCQ(OR 0.4(95%CI 0.2至0.6);p<0.01)。HCQ暴露与患cNL的风险降低相关;抗La抗体阳性和女性与患cNL风险升高相关。在仅限于系统性红斑狼疮母亲和皮疹出现≤1个月患者的分析中,HCQ暴露仍然与患cNL的风险降低显著相关。在分析全部的262例cNL病例时,HCQ暴露婴儿(6.0周(95%CI 5.7至6.3))vs.无HCQ暴露婴儿(4.4周(95%CI 3.9至5.0))的cNL起病年龄较大,但差异无统计学意义(p=0.21)。

HCQ暴露与患cNL的风险降低相关。在cNL病例中,HCQ暴露婴儿的皮疹出现较晚。这两项发现均提示HCQ对cNL具有保护性作用。

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    2019-07-29 cmj8wellington
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    2018-10-11 zhouqu_8

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