想孕育一个健康的宝宝，一定要重视产检。(记者乔军伟摄，图文无关)

Want to gave birth to a healthy baby,Must attach great importance to production.(Reporter Qiao Junwei perturbation,Graphic has nothing to do)

　　●只要将病情控制住，患者也可以像正常人一样孕育健康的孩子

Low as long as their condition under control,Patients can be like normal person gave birth to healthy children

　　●在妊娠过程中首发的红斑狼疮，尤其容易漏诊或误诊。健康孕妇若出现关节痛、血小板下降等症状需警惕“妊娠首发狼疮”

Second-ranking during pregnancy starting of lupus erythematosus (sle),Especially easily missed diagnosis or misdiagnosis.If a healthy pregnant women appear joint pain/The symptom such as platelet decline alarmingly"Pregnancy starting lupus"

　　日前，广医三院重症孕产妇救治中心收治了一名“妊娠首发狼疮”孕妇，入院后很快就出现了乱语、抽搐现象，产科医生只得立即为她进行紧急剖宫取胎。

recently,GuangYi research and severe maternal admitted a treatment center"Pregnancy starting lupus"Pregnant women,Gibberish appeared soon after admission/Tic phenomenon,The obstetrician had to immediately for an emergency for her cutting palace extraction.

　　专家介绍，红斑狼疮好发于生育期女性。以前，女性狼疮患者是不可以妊娠的。现在只要病情控制良好，红斑狼疮患者也能生宝宝了，但是，在妊娠及产后的整个过程，都需要产科和风湿科医生定期随诊，对狼疮的活动指标及胎儿情况进行定期监测。而且，孕前健康的孕妇，如果在孕期出现关节痛、血小板下降、浮肿、血压升高等情况，也应进行狼疮相关的检查，以免像这例患者一样出现“妊娠首发狼疮”。

Expert introduction,Lupus erythematosus (sle) occurs in women of reproductive years.before,You can't pregnancy women lupus patients.As long as the condition under control now,Lupus erythematosus (sle) patients can also gave birth to a baby,but,In the whole process of pregnancy and postpartum,All need maternity and FengShiKe doctors follow-up on a regular basis,In lupus activity index and fetal monitor on a regular basis.and,Prepregnancy healthy pregnant women,If appear joint pain during pregnancy/Platelet decline/edema/High blood pressure, and so on and so forth,Also should be related to lupus checks,So as not to appear like the patients"Pregnancy starting lupus".

　　文/记者黄蓉芳 通讯员黄贤君 医学指导/广州医学院第三附属医院风湿免疫科副主任医师张建瑜

Wen/reporter Huang Rongfang correspondent Huang Xianjun medical guidance/third affiliated hospital of doctor of vice director of li rheumatism lead of guangzhou medical college Zhang Jianyu

　　案例：健康孕妇突发红斑狼疮

case:Lupus erythematosus (sle) of a healthy pregnant women

　　广州医学院第三附属医院风湿免疫科副主任医师张建瑜介绍，日前，该院产科从花都接回一个叫小花(化名)的病人，怀孕两个月，一周前出现血小板下降、关节痛。

The third affiliated hospital of doctor of vice director of li rheumatism lead of the guangzhou medical college Zhang Jianyu is introduced,recently,The hospital maternity from flowers to take back a call floret(Not his real name)Of the patients,Two months pregnant,A drop in platelet a week ago/Joint pain.

　　尽管小花怀孕前是健康的，但医院根据她的症状，给她做了包括狼疮筛查在内的各种检查。入院次日，小花的病情便急转直下，出现乱语、抽搐，产科医生不得不马上为她进行紧急剖宫取胎，术后转入重症监护室。

Although flower before pregnancy is healthy,But the hospital according to her symptoms,Gave her a including lupus screening tests.The day after admission,Floret will plummet,A gibberish/tic,Obstetricians have to immediately for an emergency for her cutting palace extraction,Transferred to the intensive care unit after surgery.

　　随后的检查结果表明，系统性红斑狼疮诊断成立，而且是重型狼疮(狼疮危象)。经过大剂量激素及丙种球蛋白冲击，小花逐渐清醒，血小板很快回升，并撤离了呼吸机，但四肢仍不能动弹，一周后，再次给予激素冲击治疗，并联合使用免疫抑制剂，她才慢慢能坐、站立、行走，最终康复出院。

Test results showed that later,Diagnosis of systemic lupus erythematosus (sle),And is a heavy lupus(Lupus crisis).After a large dose of hormone and gamma globulin,Floret gradually awake,Platelet recovery soon,And leave the breathing machine,But still could not move limbs,After a week,Again given hormone shock therapy,And the combination of immunosuppressant,She just can slowly sit down/Stand up/To walk,Eventually recovered from.

　　红斑狼疮患者也能结婚生子

Lupus erythematosus (sle) patients can also marry and have children

　　张建瑜介绍，红斑狼疮是一个可引起全身各个组织、系统病变的自身免疫性疾病，好发于生育期女性。轻者会出皮疹，重者会出现脏器衰竭甚至危及生命。其临床表现包括反复皮疹、口腔溃疡、关节痛、浮肿、泡沫尿、心悸气促、头痛、腹泻、精神异常、抽搐、昏迷，或者伴有白细胞、血小板减少、血肌酐升高等。

Zhang Jianyu introduction,Lupus erythematosus (sle) is an organization that can cause the whole body all/System lesions autoimmune diseases,Good hair in women of reproductive years.Light person will be a rash,The person that weigh can appear organ failure or even life-threatening.Its clinical manifestations include rash over and over again/Oral ulcer/Joint pain/edema/A bubble urine/Heart palpitations shortness of breath/Have a headache/diarrhea/Mental disorder/tic/In a coma,Or with white blood cells/thrombocytopenia/Elevated serum creatinine, etc.

　　“而且，狼疮患者常常多种症状或多个系统损害并存。”她说，因此，患者如果同时或先后出现多个脏器或系统损害的症状，尤其是育龄期女性，应首先到风湿免疫科就诊，以免在多个专科的检查治疗中来回折腾而最终延误病情。“以前，患有红斑狼疮的女性，常常因妊娠而致病情加重甚至失去年轻的生命，因此，女性狼疮患者被禁止妊娠。”张建瑜说，随着医学的发展，红斑狼疮缓解率已大大提高，红斑狼疮患者不仅能像正常人一样生活、工作，而且也能结婚生子。

"and,Lupus patients often multiple damage symptoms or more systems coexist."She said,so,If simultaneously or successively appeared multiple organs in patients with symptoms or system damage,Especially the childbearing age women,Should be first to doctor li rheumatism lead,To avoid back and forth in multiple examination and treatment specialist for the final delay treatment."before,Women with severe lupus erythematosus (sle),Often because of pregnancy and cause illness or even the loss of young lives,so,Female lupus patients are forbidden to pregnancy."Zhang Jianyu said,With the development of medicine,Lupus erythematosus (sle) response rate has been greatly improved,Lupus erythematosus (sle) patients is not only to live like normal people/work,And also can marry and have children.

　　特别提醒：妊娠中要小心“妊娠首发狼疮”

Special remind:Be careful in pregnancy"Pregnancy starting lupus"

　　有的孕妇在孕前十分健康，并没有红斑狼疮，但在妊娠过程中，却突然出现红斑狼疮，该怎么办？张建瑜说，这就是常说的“妊娠首发狼疮”。“前文中的小花就是一个典型的例子。”她说，首次出现在孕产妇身体中的“狼”，常常非常凶险。“它们隐藏起来，很少攻击孕产妇的皮肤、关节，而是一来就直接攻击要害部位。这时候，孕产妇会出现严重肾损害、心衰、呼吸衰竭、脑血管意外等。”

Some pregnant women in pregnancy is very healthy,No lupus erythematosus (sle),But in the process of pregnancy,Suddenly appear lupus erythematosus (sle),What should I do?Zhang Jianyu said,It is often said"Pregnancy starting lupus"."Above the flower is a typical example."She said,For the first time appear in the maternal body"The Wolf",Often very dangerous."They are hidden,Rarely attack maternal skin/The joints,But would direct attacks on the key parts.At this time,Maternal can appear serious renal damage/Heart failure/Respiratory failure/Cerebrovascular accident, etc.."

　　张建瑜介绍，对于“妊娠首发狼疮”的患者，如果能获得早期确诊，尽早揪出在孕产妇身体中藏匿的“狼”，尤其是“凶残的狼”，及时地治疗，或者适时地中止妊娠，对母亲和胎儿的生命安全都意义重大。

Zhang Jianyu introduction,for"Pregnancy starting lupus"Of the patients,If we can get early diagnosis,As soon as possible find out the hiding in the maternal body"The Wolf",Especially in the"Fierce wolves",Treatment in a timely manner,Or termination as necessary,Has important significance to the safety of mother and fetus.

　　专家意见：病情缓解6个月后可考虑怀孕

Expert opinion:Remission of six months after pregnancy may be considered

　　“红斑狼疮至今仍然像大多数慢性病一样不能被治愈。”张建瑜说，“但我们发现，很大一部分患者在经过规范的治疗后，能够完全控制病情，甚至能够停药，患者的器官和身体不会再受侵害，而且可以像正常人一样孕育健康的孩子。”

"Lupus erythematosus (sle) still like most chronic disease cannot be cured."Zhang Jianyu said,"But we found that,A large part of patients after standard therapy,Can completely control the condition,Can even drug withdrawal,Patients with organ and body will not infringement,And can be like normal person gave birth to healthy children."

　　如果符合以下条件，是可以妊娠的：1.系统性红斑狼疮经正规治疗，病情缓解至少6个月，泼尼松维持量≤10mg/d；2.无系统性红斑狼疮引起的肾脏等重要内脏器官损害；3.停用免疫抑制药物6个月以上。

If you meet the following conditions,Can be pregnancy:1. The systemic lupus erythematosus (sle) by regular treatment,Remission in at least six months,Prednisone maintain 10 mg/d or less;2. No kidney caused by systemic lupus erythematosus (sle) and other important internal organs damage;3. Stop using immunosuppressive drugs more than six months.

　　张建瑜提醒，控制住病情后的红斑狼疮患者，在妊娠过程中，狼疮也有可能复发或活动。

Zhang Jianyu remind,Lupus erythematosus (sle) patients after the disease under control,In the process of pregnancy,Lupus is also likely to relapse or activity.

　　“而且，狼疮活动可能发生在妊娠的任何时期，也可能发生在分娩后的几个月内。”值得庆幸的是，大部分妊娠前病情稳定的孕产妇，在孕期或产后，狼疮活动一般病情不重，“有些仅仅表现为轻微的皮肤损害、关节疼痛，稍重的会有蛋白尿增加等肾脏损害，但是，通常加大激素量可以很容易控制。不过，偶尔也会碰到重度活动的孕产妇。”

"and,Lupus activity can occur in any period of pregnancy,May also occur in the first few months after birth."It would be nice,Most of the stable condition of maternal before pregnancy,During pregnancy or postpartum,Lupus activity generally was not ill,"Some just show the slight skin damage/Joint pain,Heavier will increase the proteinuria in kidney damage, etc,but,Usually increase the amount of hormone is easy to control.but,Occasionally encounter severe maternal."

　　张建瑜特别提醒，狼疮孕产妇在妊娠及产后的整个过程，都需要产科医生及风湿科医生的定期随诊，对狼疮的活动指标及胎儿情况进行定期监测。“狼疮孕妇的随诊密度应与正常孕妇有所区别，狼疮孕妇怀孕20周以后每2周随诊一次，28周后每周随诊一次。”

Zhang Jianyu special remind,The whole process of lupus maternal during pregnancy and postpartum,All need the obstetrician and FengShiKe doctor regular follow-up,In lupus activity index and fetal monitor on a regular basis."Lupus pregnant women with density should be different with normal pregnant women,Lupus pregnancy after 20 weeks once every 2 weeks follow-up,After 28 weeks follow-up once a week."

　　自我排查：孕期若关节痛、血小板下降需警惕

Self screening:If the joint pain during pregnancy/Platelet decline should be vigilant

　　“然而，在妊娠过程中首发的红斑狼疮，尤其容易漏诊或误诊。”张建瑜说，他们医院经常接到由基层医院转送过来的重型狼疮孕产妇，往往因为患者对自身的症状没有足够的认识，或产检医生对红斑狼疮的警惕性不高，从而延误诊断，最终导致孕妇病情危殆或胎死腹中。

"however,In the process of pregnancy starting of lupus erythematosus (sle),Especially easily missed diagnosis or misdiagnosis."Zhang Jianyu said,They often received by basic-level hospitals transferred heavy lupus maternal,Often because patients symptoms don't have enough understanding of their own,Or the doctor of vigilance is not high of lupus erythematosus (sle),To delay in diagnosis,Eventually lead to pregnant women in critical or stillborn.

　　“但是，不得不提醒的是，有一部分正常妊娠的孕妇也会出现一些关节痛、血小板下降、浮肿、血压升高等情况，这些症状与红斑狼疮的早期症状有所重叠，所以也容易导致临床诊治的不确定性。”张建瑜特别提醒，当孕妇出现关节痛、血小板下降、浮肿、血压升高等情况，产科大夫应及时请风湿免疫科医生会诊，以确定是否存在妊娠首发狼疮。

"but,Have to remind of is,Part of the normal pregnant women of pregnancy also can appear some joint pain/Platelet decline/edema/High blood pressure, and so on and so forth,These symptoms with early symptoms of lupus erythematosus overlap,So also easy to cause the uncertainty of clinical diagnosis and treatment."Zhang Jianyu special remind,When pregnant women appeared joint pain/Platelet decline/edema/High blood pressure, and so on and so forth,Obstetrician should timely please doctor li rheumatism lead of the consultation,To determine whether there is a pregnancy starting lupus.