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系统性红斑狼疮是主要累及生育年龄女性的自身免疫性疾病,但不影响生育能力。新近更多的前瞻性研究表明,狼疮静止期妊娠对母亲来讲是安全的。狼疮性肾炎孕妇的胎儿和母亲的预后与怀孕时的狼疮活跃情况、肾功能、抗磷脂抗体的存在有很强的相关性。为避免肾脏的并发症,建议怀孕后给予适当激素预防,并在预计分娩前几天及分娩后强化激素治疗,然后快速减至产前维持剂量。妊娠时狼疮活跃的治疗药物包括皮质激素、羟氯喹、硫唑嘌呤、环胞素A等。血压控制可选择的药物包括甲基多巴、拉贝洛尔、硝苯地平等。
Systemic lupus erythematosus is an autoimmune disease that mainly affects women of childbearing age but does not affect fertility. More recent prospective studies have shown that resting lupus pregnancy is safe for mothers. The prognosis of fetuses and mothers with lupus nephritis in pregnant women is strongly correlated with the prevalence of lupus during pregnancy, renal function, and the presence of antiphospholipid antibodies. To avoid kidney complications, it is advisable to give appropriate hormonal prophylaxis after pregnancy and to intensify the hormone therapy a few days prior to delivery and after childbirth, before rapidly reducing to the prenatal maintenance dose. Pregnancy lupus active treatment drugs include corticosteroids, hydroxychloroquine, azathioprine, cyclosporin A and so on. Drugs of choice for blood pressure control include methyldopa, labetalol, nifedipine and the like.