系统性红斑狼疮患者何时可以考虑妊娠?

2016-03-25 佚名 中华医学杂志

系统性红斑狼疮(SLE)患者必须同时满足下述条件才可以考虑妊娠 1)病情不活动且保持稳定至少6个月; 2)糖皮质激素的使用剂量为泼尼松 15mg/d(或相当剂量)以下; 3)24h尿蛋白排泄定量为0.5克以下; 4)无重要脏器损害; 5)停用免疫抑制药物如环磷酰胺、甲氨蝶呤、雷公藤、霉酚酸酯等至少6个月

中国系统性红斑狼疮研究协作组专家组

系统性红斑狼疮(SLE)患者必须同时满足下述条件才可以考虑妊娠

1)病情不活动且保持稳定至少6个月;

2)糖皮质激素的使用剂量为泼尼松 15mg/d(或相当剂量)以下;

3)24h尿蛋白排泄定量为0.5克以下;

4)无重要脏器损害;

5)停用免疫抑制药物如环磷酰胺、甲氨蝶呤、雷公藤、霉酚酸酯等至少6个月;对于服用来氟米特的患者,建议先进行药物清除治疗后,再停药至少6个月后才可以考虑妊娠。

以下情况属于妊娠禁忌证

1)严重的肺动脉高压(估测肺动脉收缩压>50mmHg,或出现肺动脉高压的临床症状);

2)重度限制性肺部病变(用力肺活量(FVC)<1 升);

3)心功能衰竭;

4)慢性肾功能衰竭(血肌酐SCr >2.8mg/dl);

5)既往有严重的子痫前期或即使经过阿司匹林和肝素治疗仍不能控制的HELLP综合征;

6)过去6个月内出现脑卒中;

7)过去6个月内有严重的狼疮病情活动。

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    2018-03-02 spake

    说的很详细.谢谢分享

    0

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    2016-03-27 zhouqu_8
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    2016-03-25 1de304d2m86(暂无匿称)

    值得学习

    0

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关节表现常常是系统性红斑狼疮(SLE)患者最常见和最早出现的临床症状。临床判断SLE的关节病变常应用ACR非侵蚀性关节炎的诊断标准,但SLE也有非侵蚀性变形性关节炎(Jaccoud关节)和伴关节侵蚀畸形的关节炎(Rhupus综合征)。而目前对SLE关节炎的研究却较少。 为了探讨核磁共振(MRI)在SLE关节炎的诊断价值和SLE关节炎的临床特点,爱尔兰的Ball教授等做了一项病例对照研究,