ABSTRACT
Objective To analyze the clinical characteristics,the complications and the difference of pregnancy outcome of the patients with systemic lupus erythematosus (SLE) during the different timing of gestation so as to guide the rational pregnancy of the patients with SLE.Methods A systematic review of the clinical data of 96 patients with SLE from January 2000 to January 2018,in Nanjing Hospital Affiliated to Nanjing Medical University,was systematically reviewed,including 60 cases of guiding pregnancy group and 36 cases of non guiding pregnancy group.The general situation,clinical characteristics,pregnancy complications and pregnancy outcome were compared and statistically analyzed.Results There was no significant difference in age and pregnancy between guiding pregnancy group and non guiding pregnancy group (P＞0.05).The rate of lupus activity in guiding group during pregnancy was lower than that in non guiding pregnancy group:25.0％ (15/60) vs.100.0％ (36/36),and the difference was statistically significant (P＜0.01).The main clinical manifestations of SLE during pregnancy were thrombocytopenia,lupus nephritis and rash.The other was infection,arthritis and so on.Among them,the incidences of thrombocytopenia,lupus nephritis and rash in guiding pregnancy group were lower than those in non guiding pregnancy group,and the differences were statistically significant (P＜0.05 or ＜0.01).The incidences of preeclampsia,preterm birth,fetal intrauterine growth restriction (IUGR),low birth weight infants (LBW) and fetal distress in the guiding pregnancy group were lower than those in non guiding pregnancy group,but the difference was not statistically significant (P＞0.05).The pregnancy loss rate was lower and the live birth rate of the guiding pregnancy group was significantly higher than those in non guiding pregnancy group:0 vs.33.3％ (12/36),100.0％ (60/60) vs.66.7％ (24/36),and the differences was statistically significant (P＜0.05).In the guiding pregnancy group,the gestational weeks of termination of pregnancy and the weight of the newborn were greater than those in the non guiding pregnancy group (except for those with pregnancy loss):(269.4 ± 8.0) d vs.(250.8 ± 18.5) d,(3 005.2 ± 305.9) g vs.(2 462.5 ± 507.6) g,and the differences were statistically significant (P＜0.05).The rate of cesarean section in guiding pregnancy group was lower than that in non guiding pregnancy group,and the difference was statistically significant (P=0.019).The mortality rate of pregnant women in guiding pregnancy group was lower than that in non guiding pregnancy group,but there was no statistical difference (P=0.133).Conclusions The main clinical features of pregnancy with SLE during pregnancy are thrombocytopenia,lupus nephritis and rash.Disease activity can increase the incidences of thrombocytopenia,lupus nephritis and rash.In the guiding pregnancy group,the rate of lupus activity during pregnancy is significantly lower than that in the non guiding pregnancy group,and the complications during pregnancy are decreased.Lupus activity is an important factor affecting pregnancy outcome.Choosing the remission stage and control period is the key for successful SLE pregnancy.SLE patients have higher risk of complications than normal people,such as preeclampsia,premature birth,IUGR,LBW,pregnancy loss,and so on.SLE patients should strengthen maternal and child monitoring during pregnancy to minimize perinatal complications and improve perinatal quality.
ABSTRACT
Objective To evaluate clinical efficacy and safety of levornidazole in the treatment of pelvic anaerobic infections. Methods A multicenter randomized controlled clinical study was conducted to evaluate clinical efficacy and safety of levornidazole. One hundred and fourty-three patients with pelvic anaerobic bacteria infection were classified into 70 cases treated by levornidazole in study group and 73 cases treated by Ornidazole in control group. Those patients in two groups were both administered at a dose of 0. 5 g twice daily for 5 - 7 days. The rate of clinical efficacy, bacteria clearance and adverse effect were recorded and compared between two groups. Results At the endpoint, the rate of clinical efficacy were 80% (56/70) in study group and 81% (59/73) in control group, which did not reach significant difference (P＞0. 05). The rate of bacteria clearance were 97% (36/37) in study group and 92% (22/24) in control group, which also did not reach significant difference(P ＞0. 05). The rate of adverse reaction of 3% (20/70) in study group was significantly lower than 22% ( 16/73 ) in control group ( P ＜ 0. 05 ). Conclusion It is effective and safe to treat pelvic anaerobic infections with levornidazole and sodium chloride injection.