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系统性红斑狼疮女性患者使用避孕方法的安全 |
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diseaseactivityinwomenwithinactiveorstableactiveSLE.Noincreaseindiseaseactivitywithuseofprogestogen-onlycontraceptiveswasnotedinfourstudies.Limitedevidenceindicatesapossibleincreasedriskofthrombosisinwomenwithpositiveantiphospholipidantibodiesandhistoryoforalcontraceptiveuse.LimitedevidenceindicatesthattheuseofthecopperintrauterinedeviceisnotassociatedwithworseningdiseaseactivityorinfectioninwomenwithSLE.CONCLUSION:AvailableevidenceindicatesthatmanywomenwithSLEcanbeconsideredgoodcandidatesformostcontraceptivemethods,includinghormonalcontraceptives.ThebenefitsofcontraceptionformanywomenwithSLElikelyoutweightherisksofunintendedpregnancyinthispopulation.Womenwithpositiveantiphospholipidantibodiesarenotgoodcandidatesforcombinedhormonalcontraceptiongiventheirelevatedbaselineriskofthrombosis. 专家评价：RaymondLiandPakChungHoQueenMaryHospital,ChinaWomen sHealthChangesClinicalPractice:Forwomenwithinactiveorstableactivesystemiclupuserythematosus（SLE）andabsenceofanti-phospholipidantibodies,theuseofhormonalcontraceptivesisasafecontraceptiveoption.Thissystematicreviewsuggeststhattheuseofhormonalcontraceptivesissafeinmostwomenwithuncomplicatedsystemiclupuserythematosus（SLE）andthatthebenefitsofgoodcontraceptionoutweightherisksinthesepatients;theexceptionwerewomenwithpositiveanti-phospholipidantibodies,whoarenotgoodcandidatesforcombinedhormonalcontraceptivesbecauseoftheirincreasedthromboticrisk.Thisisasystematicreviewof13studies,includingtwogood-qualityrandomizedcontrolledtrials（RCTs）,ontheuseofhormonalcontraceptivemethods（combinedoralcontraceptives[COCs]andprogestogen-onlypills[POPs]）inwomenwithSLE.ThetwoRCTsconcludedthattheuseofCOCsdidnotleadtoincreasedflaresofdiseaseorworseningofdiseaseactivityinwomenwithinactiveorstableactiveSLE.Fournon-RCTsshowedthattheuseofPOPsdidnotresultinincreaseddiseaseactivity.Therewassomeevidenceshowinganincreasedthromboticriskinwomenwithpositiveanti-phospholipidantibodiesusinghormonalcontraceptives.Twostudiessuggestedthattheuseoforalcontraceptivesred 上一页 [1] [2] [3] 下一页
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