Shibata S, Sasaki T, Hirabayashi Y, Seino J, Okamura K, Yoshinaga K, Morito N, Kasukawa R, Aotuka S, Yokohari R
Second Department of Internal Medicine, Tohoku University School of Medicine, Sendai, Japan.
Ann Rheum Dis. 1992 May;51(5):619-23. doi: 10.1136/ard.51.5.619.
Fetal wastage is still high in the pregnancies of patients with systemic lupus erythematosus (SLE). We examined retrospectively the cases of 38 patients with inactive SLE in whom pregnancy was either desired or had already been obtained. The prevalence of antiphospholipid antibodies in the group with fetal loss was high. The antibodies were, however, also detected in five of 14 patients who had had a live birth. It was noted that low levels of serum complement activity (CH50 less than 25 U/ml) occurred in five of six patients with fetal loss, but in only two of 22 with a live birth. Serial studies also confirmed a close association between decreased serum complement activity and poor fetal prognosis in lupus pregnancy. Treatment with increased doses of prednisolone may help to achieve successful live births. Thus hypocomplementaemia may be associated with a worse prognosis for the fetus in the pregnancies of some patients with SLE in remission.
系统性红斑狼疮（SLE）患者妊娠时的胎儿丢失率仍然很高。我们回顾性研究了38例病情稳定的SLE患者，这些患者或者渴望怀孕，或者已经怀孕。胎儿丢失组中抗磷脂抗体的患病率很高。然而，在14例活产患者中也有5例检测到了这些抗体。值得注意的是，6例胎儿丢失患者中有5例血清补体活性水平较低（CH50低于25 U/ml），而22例活产患者中只有2例如此。系列研究还证实，狼疮妊娠中血清补体活性降低与胎儿预后不良密切相关。增加泼尼松龙剂量进行治疗可能有助于实现成功活产。因此，在一些病情缓解的SLE患者妊娠中，补体血症可能与胎儿预后较差有关。
