北京大学学报（医学版）2023，Vol.55Issue(6)：1045-1052,8.DOI:10.19723/j.issn.1671-167X.2023.06.014
未分化结缔组织病患者的妊娠结局、疾病演变及其影响因素
Analysis of pregnancy outcomes,disease progression,and risk factors in patients with undifferentiated connective tissue disease
摘要
Abstract
Objective:To investigate the fetal and maternal outcomes,risk factors of disease progres-sion and adverse pregnancy outcomes(APOs)in patients with undifferentiated connective tissue disease(UCTD).Methods:This retrospective study described the outcomes of 106 pregnancies in patients with UCTD.The patients were divided into APOs group(n=53)and non-APOs group(n=53).The APOs were defined as miscarriage,premature birth,pre-eclampsia,premature rupture of membranes(PROM),intrauterine growth restriction(IUGR),postpartum hemorrhage(PPH),and stillbirth,small for gestational age infant(SGA),low birth weight infant(LBW)and birth defects.The differences in clinical manifestations,laboratory data and pregnancy outcomes between the two groups were compared.Logistic regression analysis was performed to analyze the risk factors for APOs and the progression of UCTD to definitive CTD.Results:There were 99(93.39％)live births,4(3.77％)stillbirths and 3(2.83％)miscarriage,20(18.86％)preterm delivery,6(5.66％)SGA,17(16.03％)LBW,11(10.37％)pre-eclampsia,7(6.60％)cases IUGR,19(17.92％)cases PROM,10(9.43％)cases PPH.Compared with the patients without APOs,the patients with APOs had a higher positive rate of anti-SSA antibodies(73.58％vs.54.71％,P=0.036),higher rate of leukopenia(15.09％vs.3.77％,P=0.046),lower haemoglobin level[109.00(99.50,118.00)g/L vs.124.00(111.50,132.00)g/L,P＜0.001].Multivariate Logistic regression analysis showed that leucopenia(OR=0.82,95％CI:0.688-0.994)was an independent risk factors for APOs in UCTD(P=0.042).Within a mean follow-up time of 5.00(3.00,7.00)years,the rate of disease progression to a definite CTD was 14.15％,including 8(7.54％)Sjögren's syndrome,4(3.77％)systemic lupus erythematosus(SLE),4(3.77％)rheumatoid arthritis and 1(0.94％)mixed connective tissue disease.Multivariate Cox proportional risk regression analysis showed that Raynaud phenomenon(HR=40.157,95％CI:3.172-508.326)was an independent risk factor for progression to SLE.Conclusion:Leukopenia is an independent risk factor for the development of APOs in patients with UCTD.Raynaud's phenmon is a risk factor for the progression of SLE.Tight disease monitoring and regular follow-up are the key measures to prevent adverse pregnancy outcomes and predict disease progression in UCTD patients with pregnancy.关键词
未分化结缔组织病/不良妊娠结局/危险因素Key words
Undifferentiated connective tissue disease/Adverse pregnancy outcomes/Risk factor分类
医药卫生引用本文复制引用
游芳凝,罗靓,刘香君,张学武,李春..未分化结缔组织病患者的妊娠结局、疾病演变及其影响因素[J].北京大学学报（医学版）,2023,55(6):1045-1052,8.基金项目
中华国际医学交流基金(Z-2018-40-2101)和北京市科技计划项目(Z191100006619110)Supported by China International Medical Foundation(Z-2018-40-2101)and Beijing Municipal Science and Technology Projects(Z191100006619110) （Z-2018-40-2101）
