Compare Of Evaluation Of Systemic Lupus Erythematosus Activity During Pregnancy In Two Methods

Objective:The analysis of 32 pregnancies with systemic lupus erythematosus to diagnose systemic lupus erythematosus activity during pregnancy and discuss pregnancy complications and pregnancy outcome. Method:32 pregnancies from January 1st of 2004 to December 31 st of 2014 in first affiliated hospital of Dalian Medical University were evaluated retrospectivel. Objects of study were divided into two groups:the clinician experience and LAI-P, If there is a difference between two methods. Results:1. General situation: the average age of 32 cases was 30.9 ± 3.7 years(25-39years), average pregnancy for 2 times(1-5 times), the average production time for 1 time(0-3times), history of systemic lupus erythematosus from 0.01 years to 18 years. Term birth was 20 cases, 3 cases of premature, 9 cases of abortion.2. Compare between clinical experience with LAI- PGrouping compare:On the basis of clinical experience, 14 cases in lupus activity 18 cases in stable lupus. On the basis of LAI-P :lupus activity was 22 cases, inactivity was 10 cases, there was most significant difference between two groups(P =0.008<0.05). Kappa=0.552, matches are generally.To the clinician experience as the standard: the sensitivity of the LAI- P was 100%(95% CI, 76.8 to 95%), specifcity was 55.6%(95% CI, 30.8 to 95%), accuracy was 75%, positive predictive value of 0.636, negative predictive value is 1, positive likelihood ratio was 2.25(95% CI, 1.5 to 3.4), and negative likelihood ratio of 0.3. Comparison of complications3.1 The incidence of abortion, premature delivery and preeclampsia, statistical analysis showed that there was no significant difference(P > 0/05).3.2 8 of pregnancies was activety in LAI- P,but inactivety in clinician experience.Miscarriage, preeclampsia and double lower limbs vein thrombosis was one case, respectively.4. Compare of clinical indicatorsIn three indicators(prednisone > 0.5 mg/Kg · d, platelet < 20 x 109 / L),which’s socre was higher,there is no difference in both active and inactive group in two methods.In the prednisone or hydroxychloroquine ≦ 0.5 mg/Kg · d, platelet > 20 x 109 / L, proteinuria < 3 g / 24 h(low scores early changes),in activity group of LAI-P were obviously higher than clinical experience, and the contrary is the case in stable lupus.Statistical analysis showed that there was no statistically significant difference.5. LAI- P : active group term birth was 10 cases, premature delivery in 3, 9 cases of abortion, when delivery or after delivery application hormone added or shock treatment was 10 cases, inactive group there were 10 cases in term of groups, no premature birth or abortion cases, only 3 cases of application of hormone and the amount or shock treatment when delivering or after delivery Conclusion:1. LAI – P can assessment systemic lupus erythematosus whether activity during pregnancy.2. LAI- P can predict systemic lupus erythematosus activity during pregnancy earlier, and the incidence of pregnancy complications in systemic lupus erythematosus activity is higher, the pregnancy outcome is worse, it is recommended that the diagnosis and early treatment of systemic lupus erythematosus activity during pregnancy should be more earlier.3. The change of drugs, platelet, proteinuria etc, maybe prompt systemic lupus erythematosus activity during pregnancy.