类风湿关节炎在孕期及产后的疾病活动度能否预测后续孕期的疾病活动度？
Is Disease Activity in Rheumatoid Arthritis during Pregnancy and after Delivery Predictive for Disease Activity in a Subsequent Pregnancy?
作者信息
Ince-Askan Hilal, Hazes Johanna M W, Dolhain Radboud J E M
机构信息
From the Department of Rheumatology, Erasmus Medical Center, Rotterdam, the Netherlands.H. Ince-Askan, MD, Department of Rheumatology, Erasmus Medical Center; J.M. Hazes, MD, PhD, Department of Rheumatology, Erasmus Medical Center; R.J. Dolhain, MD, PhD, Department of Rheumatology, Erasmus Medical Center.
出版信息
J Rheumatol. 2016 Jan;43(1):22-5. doi: 10.3899/jrheum.150565. Epub 2015 Dec 1.
OBJECTIVE
To determine whether disease activity in women with rheumatoid arthritis (RA) in 1 pregnancy is predictive for disease activity in a subsequent pregnancy.
METHODS
In the Pregnancy-induced Amelioration of Rheumatoid Arthritis study, there are prospective data on 27 patients who participated twice. Improvement and deterioration is determined by changes in the Disease Activity Score in 28 joints.
RESULTS
Only 4 patients (14.8%) had comparable disease courses in both pregnancies, whereas treatment remained mostly similar. In contrast, a flare postpartum after the first pregnancy was predictive for a flare after the second pregnancy (p = 0.003).
CONCLUSION
RA disease course in following pregnancies cannot be predicted based upon previous pregnancies. However, a flare postpartum seems to predict subsequent flares.
目的
确定类风湿关节炎（RA）女性患者在一次妊娠期间的疾病活动度是否可预测随后妊娠时的疾病活动度。
方法
在类风湿关节炎妊娠诱导改善研究中，有27名患者两次参与研究的前瞻性数据。通过28个关节的疾病活动评分变化来确定病情改善和恶化情况。
结果
仅4名患者（14.8%）在两次妊娠中的疾病病程具有可比性，而治疗大多保持相似。相比之下，第一次妊娠后产后病情复发可预测第二次妊娠后病情复发（p = 0.003）。
结论
无法根据既往妊娠情况预测后续妊娠时的类风湿关节炎病程。然而，产后病情复发似乎可预测随后的病情复发。
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