Objective To investigate and analyze the related factors of pregnancy outcomes in pregnant patients with systemic lupus erythematosus (SLE).Methods Altogether 100 pregnant patients with SLE admitted in department of obstetrics and gynecology in Heze Second People's Hospital of Shandong Province from February 2006 to February 2015 were selected and divided into successful pregnancy group and failed pregnancy group according to whether patients had successful pregnancy and live birth or not.Incidences of Raynaud's phenomenon, hypertension and low complement C3 and C4, SLE recurrence rate, positive rate of anti-Ro/SSA antibody and anticardiolipin antibody (aCL), incidence of lupus nephritis, positive rate of anti single strand binding protein (anti La/SSB antibody) in two groups were observed and collected for analysis.Results There was no significant correlation between duration of SLE, age of patients and adverse pregnancy outcomes, and the difference was not statistically significant (χ2 value was 1.344 and 2.413, respectively, both P>0.05).Gestational age was associated with adverse pregnancy outcomes, and gestational age of patients in failed pregnancy group was less than that in successful pregnancy group with significant difference (χ2=5.782, P=0.035).Incidences of Raynaud's phenomenon, hypertension and low complement C3 and C4, positive rate of anti-Ro/SSA antibody and anti La/SSB antibody in two groups were statistically analyzed and differences had no statistical significance (χ2 value was 2.18, 2.23, 1.87, 2.14 and 2.33, respectively, all P>0.05).Lupus nephritis incidence, anti aCL positive rate, SLE recurrence rate in failed pregnancy group were significantly higher than those in successful pregnancy group (χ2 value was 4.45, 8.36 and 5.16, respectively, all P<0.05).Logistic regression analysis showed that important influencing factors related to adverse pregnancy outcomes of patients included incidence of Raynaud's phenomenon, incidence of hypertension, low complement C3 and C4 incidence, recurrence of SLE, positive rate of anti Ro/SSA antibody, anti aCL positive rate, incidence of lupus nephritis, and positive rate of anti La/ SSB antibody, and differences were statistically significant (OR value was 1.15, 1.38, 1.20, 1.33, 1.19, 1.48, 1.24 and 1.23, respectively, all P<0.05).Conclusion Important influencing factors related to adverse pregnancy outcomes of patients include Raynaud's phenomenon incidence, incidence of hypertension, low complement C3 and C4 incidence, recurrence of SLE, positive rates of anti Ro/SSA antibody and anti aCL antibody, incidence of lupus nephritis, and positive rate of anti La/SSB antibody.Therefore, in order to reduce or avoid the occurrence of adverse pregnancy outcomes in pregnant patients with SLE, patients should be treated under combined efforts of experts in obstetrics and rheumatism.Relevant immune indexes of patients should be monitored during pregnancy and after delivery.Patient's pregnancy should be put under planned management, so that patient's pregnancy outcomes can be effectively improved.%目的 探讨并分析系统性红斑狼疮(SLE)合并妊娠患者妊娠结局的相关影响因素.方法 选取山东省菏泽市第二人民医院妇产科于2006年2月至2015年2月期间收治的SLE合并妊娠患者100例,根据患者妊娠成功并分娩活婴与否分为成功妊娠组和失败妊娠组两组.观察并采集两组患者的雷诺现象发生率、高血压发生率、低补体C3及C4发生率、狼疮复发率、抗 Ro/ SSA 抗体阳性率、抗心磷脂抗体(aCL)阳性率、狼疮性肾炎发生率、抗 La/ SSB 抗体阳性率等的资料,进行统计分析.结果 患者的SLE持续时间、年龄与患者不良妊娠结局无明显关联,差异不具有统计学意义(χ2值分别为1.344、2.413,均P>0.05),孕周与患者不良妊娠结局有一定关联,失败妊娠组患者孕周少于成功妊娠组,差异有统计学意义(χ2=5.782,P=0.035).两组患者的雷诺现象发生率、高血压发生率、低补体C3及C4发生率、抗 Ro/SSA抗体阳性率、抗La/SSB 抗体阳性率进行统计分析,差异比较不具有统计学意义(χ2值分别为2.18、2.23、1.87、2.14、2.33,均P>0.05),失败妊娠组狼疮性肾炎、抗aCL阳性、狼疮复发发生率均显著高于成功妊娠组(χ2值分别为4.45、8.36、5.16,均P<0.05).Logistic回归分析果显示患者不良妊娠结局的相关重要影响因素包括雷诺现象发生率、高血压发生率、低补体C3及C4发生率、狼疮复发率、抗 Ro/SSA 抗体阳性率、抗aCL阳性率、狼疮性肾炎发生率、抗 La/SSB 抗体阳性率,差异有统计学意义(OR值分别为1.15、1.38、1.20、1.33、1.19、1.48、1.24、1.23,均P<0.05).结论 患者不良妊娠结局的相关重要影响因素包括雷诺现象发生率、高血压发生率、低补体C3及C4发生率、狼疮复发率、抗 Ro/SSA 抗体阳性率、抗aCL阳性率、狼疮性肾炎发生率、抗 La/SSB 抗体阳性率;故此,为减少或避免SLE 合并妊娠患者发生不良妊娠结局,产科和风湿病专家共同处理患者,在患者孕期和产后监测相关免疫指标,对患者的妊娠进行有计划的管理,从而使患者妊娠结局得到有效改善.
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