Petri M, Howard D, Repke J
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Arthritis Rheum. 1991 Dec;34(12):1538-45. doi: 10.1002/art.1780341210.
To determine whether pregnancy is associated with an increased rate of flare in patients with systemic lupus erythematosus (SLE), we prospectively studied 40 pregnancies in 37 women with SLE. The women were evaluated on a monthly basis in the Hopkins Lupus Pregnancy Center. Flare was designated using a previously developed quantitative definition, i.e., a change of greater than 1.0 in the physician's global assessment (scale of 0-3) since the preceding visit or during the last 93 days. Flare occurred in 24 (60%) of the pregnancies. Flares presented most commonly as constitutional symptoms, renal involvement, or involvement of skin or joints. Comparison of the rates of flare in the same patients after delivery and in nonpregnant SLE patients showed a significant increase in the rate of flare during pregnancy (P less than 0.001 and P less than 0.0001, respectively). We conclude that flare of lupus during pregnancy is common and occurs significantly more frequently than does flare in nonpregnant SLE patients or in the same patients after pregnancy.
为了确定妊娠是否与系统性红斑狼疮（SLE）患者病情加重率增加相关，我们前瞻性地研究了37例SLE女性患者的40次妊娠情况。这些女性在霍普金斯狼疮妊娠中心每月接受评估。病情加重采用先前制定的定量定义，即自上次就诊以来或在过去93天内，医生整体评估（0 - 3级）变化大于1.0。24次（60%）妊娠出现病情加重。病情加重最常见的表现为全身症状、肾脏受累或皮肤或关节受累。对同一患者产后病情加重率与非妊娠SLE患者进行比较，结果显示妊娠期间病情加重率显著增加（分别为P < 0.001和P < 0.0001）。我们得出结论，妊娠期间狼疮病情加重很常见，且比非妊娠SLE患者或同一患者妊娠后病情加重更为频繁。
