自身免疫性肝炎在孕前-妊娠-产后期的管理
DOI: 10.3969/j.issn.1001-5256.2022.08.034
利益冲突声明:所有作者均声明不存在利益冲突。
作者贡献声明:李春燕参与拟定写作思路,收集分析文献,论文撰写及修改;徐文娇、邵利梅参与指导撰写文章及文章修改;汤善宏负责拟定写作方向,指导撰写文章与最后定稿。
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摘要: 自身免疫性肝炎是由自身免疫系统攻击肝细胞导致的慢性进行性肝脏炎症性疾病,以血清自身抗体阳性、高IgG和/或γ-球蛋白血症为特征。目前对自身免疫性肝炎患者妊娠的研究大多集中于分娩并发症,而对于孕前期、妊娠期、产后疾病的评估、治疗以及管理缺少系统的建议。虽然孕妇免疫会受到抑制,但如果在孕前1年疾病控制不佳或妊娠期自行停用药物会显著增加妊娠不良结局,故本文旨在叙述如何开展多学科协作及围绕妊娠期开展全周期的共同管理以提高母胎安全。Abstract: Autoimmune hepatitis (AIH) is a chronic progressive inflammatory disease of the liver caused by the attack of liver cells by the autoimmune system, with the features of positive serum autoantibodies, high IgG, and/or γ-globulinemia. Current studies on pregnancy in patients with AIH mainly focus on labor complications, and there is still a lack of systematic recommendations for the evaluation, treatment, and management of diseases in the progestational stage, during pregnancy, and after delivery. Although immunity is suppressed during pregnancy, poor disease control within one year before pregnancy and spontaneous drug withdrawal during pregnancy can significantly increase adverse pregnancy outcomes. Therefore, this article describes how to implement multidisciplinary collaboration and management of the whole cycle of pregnancy, so as to improve maternal and fetal safety.
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Key words:
- Hepatitis, Autoimmune /
- Pregnancy /
- Pregnant Women
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