医药导报2017，Vol.36Issue(11)：1219-1224,6.DOI:10.3870/j.issn.1004-0781.2017.11.002
1例计划妊娠系统性红斑狼疮患者的治疗方案及避孕措施选择
Therapeutic Regimen and Contraceptive Choice in Systemic Lupus Erythematosus Patients with Pregnancy Intendedness:a Case Report
摘要
Abstract
Objective To explore the therapeutic regimens and contraception methods in systemic lupus erythematosus ( SLE) patients with planned pregnancy . Methods Case report of a SLE patient expecting her second child and review of relevant literature were presented. The prognosis for pregnancy in SLE patients was discussed, the safety profile of medications used to treat SLE during pregnancy was analyzed and the efficacy, side effects of different contraceptive methods were compared. Results For SLE patients with high disease activity, the use of progestin-only contraceptives were advised to avoid thromboembolic risk and risk of disease flare. Patients were usually treated with high doses of systemic glucocorticoids in combination with mycophenolate mofetil (induction therapy) to control the disease.Pregnancy should be avoided until the disease was inactive for at least six months with a low-dose glucocorticoid (eg, 5 to 15 mg of prednisone per day).Azathioprine (not exceed 2 mg·kg-1 ·d-1 ) for maintaining remission was considered relatively safe during pregnancy, the use of cyclosporine or tacrolimus may also be acceptable in patients intolerant to azathioprine. Conclusion Ideally, all pregnancies in patients with SLE should be planned during periods of disease quiescence for at least six months. The safety and efficacy of medications and contraceptive methods must be reviewed and adjusted prior to conception with the goal of maintaining disease control and optimizing maternal outcomes.关键词
红斑狼疮,系统性/药学监护/妊娠,计划/免疫抑制/避孕Key words
Lupus erythematosus/Systemic/Pharmaceutical care/Pregnancy/intendedness/Immunosuppressive/Contraception分类
医药卫生引用本文复制引用
刘心霞,杨勇,陈诚,唐崑..1例计划妊娠系统性红斑狼疮患者的治疗方案及避孕措施选择[J].医药导报,2017,36(11):1219-1224,6.基金项目
四川省卫生和计划生育委员会科研课题(150200) （150200）
