妊娠期视神经脊髓炎及其治疗选择.PDFVIP

临床药物治疗杂志 2014 年 3 月第 12 卷第 2 期 Clinical Medication Journal,Mar.2014,Vol.12,No.2 ·综述· 妊娠期视神经脊髓炎及其治疗选择 耿同超 清华大学玉泉医院神经科 （北京 10004 9 ） 【摘要】 目的：分析妊娠期对视神经脊髓炎的影响和治疗选择。方法：总结分析近年来妊娠期 对视神经脊髓炎的影响和治疗选择的文章。结果和结论：视神经脊髓炎是一种中枢神经系统慢性自 身免疫性疾病，主要发生在生育期女性。妊娠可以触发疾病发生或加重病情，疾病可以增加产科并 发症风险, 但绝大多数妊娠获得成功结果。妊娠期病情波动可以采用静脉大剂量甲基泼尼龙、免疫 球蛋白、血浆交换等治疗，以及激素联合免疫球蛋白或血浆交换治疗。病情缓解至少半年后妊娠或 许有利于母婴健康，分娩后恢复维持治疗有助于预防疾病复发。 【关键词】妊娠期；视神经脊髓炎；治疗 【中图分类号】R744.52; R714.14 【文献标志码】A doi:10.3969/j .issn.1672-3384.2014.02.004 Neuromyelitis Optic of Pregnancy and its Option of Treatment GENG Tong-chao. Department of Neurology, Yuquan Hospital of Tsinghua University, Beij ing 100049,China Abstract Objective: To analyze effect of pregnancy on neuromyelitis optic and its option of 【 】 treatments. Methods:We collected and analyzed publications on neuromyelitis optic of pregnancy and its options of treatments. Results and Comclusion:Neuromyelitis optic is a chronic, autoimmune disease of the central nervous system that predominantly occurs in women of childbearing age. Pregnancy may trigger and exacerbate the disease. The disease may increase the risk of obstetric complications. However, the majority of pregnancies end in success. The flares of neuromyelitis optic associated with pregnancy can be treated by high-dose intravenous methylprednisolone, immunoglobulin, plasma exchange, and the combination of steroid and immunoglobulin, or plasma exchange. The remission of disease at least six months before conception may be better for both mother and child. Maternal health and fetal development should be closely monitored by both obstetrician and neurologist during pregnancy. The restoration treatment in postpartum helps protect against the relapse. Keywords Pregnancy; Neuromyelitis optic; Treatment 【 】 视 神 经 脊 髓 炎 泛 指 视 神 经 脊 髓 炎 谱 系疾 病 1 妊娠期母体免疫系统变化 是 一 种