摘要
目的:探讨神经精神性狼疮(NPLE)的临床特征、实验室检查情况和活动性评分。方法:回顾性分析25例.NPLE患者的临床资料,同时将160例非NPL.E患者设为对照组,比较两组患者的临床表现及实验室检查情况。根据有无癫痫发作将NPLE组分为两亚组,比较亚组间相关指标的差异。结果:SLE患者中NPLE患者占13.9%,且多发生在SLE的早期(前3年占68%)及活动期(SLEDAI 10分者占88%)。25例NPLE患者中癫痫发作(21.4%)、头痛(12.5%)和情绪障碍(12.5%)。NPLE患者常并发多系统损害(92%),以血液系统损害(68%)和狼疮性肾炎(44%)常见。NPLE组血沉增高、血小板减少及皮肤血管炎的发生率高于非NPLE组(P<0.05)。NPLE患者中癫痫发作组抗SSA抗体、抗Sm抗体阳性率显著高于无癫痫发作组(P<0.05)。NPLE患者脑电图、脑部CT、磁共振(MRI)检查多正常或轻度非特异性改变。结论:NPLE多发生在SLE的早期及活动期;NPLE神经精神学表现以癫痫发作及头痛常见;SLE患者出现血沉增高、血小板减少及皮肤血管炎并有神经精神症状时,应考虑NPLe的可能:抗SSA抗体及抗Sm抗体可作为NPLE患者癫痫发作的参考指标。
Objetive： To invetigate the clinical manifestations, diagnostic examinations, and activity scores in NPLE. Methods： A retrospective analysis was made on 25 NPLE patients. Meanwhile 160 non NPLE patients were included as control group. We compared two groups of patients with clinical manifestations and auxiliary examination. Moreover we divided the NPLE group into two subgroups by occuring seizures or not, and further compared the discrepancy between relating indexes. Results： NPLE accounted for 13.9% of SLE patients. NPLE usually occurred at the early stage of SLE（68% occuring in the tirst three years） and at the active stage of SLE （88% having SLEDAI≥10）. The 25 cases showed seizures （21.4%）, headaches （12.5%） and emotional disorders （12.5%）. 92% of NPLE patients were accompanied with the impairment of other systems or organs, and abnormalities of blood system （68%） and lupus nephritis （44%） were the most offen. Not only the incidence of elevated ESR, but also thrombocytopenia and cutaneous vasculitis of the patients in NPLE group were higher than in non-NPLE group （P〈0.05）. Compared with the NPLE patients with seizure, the positive rate of anti-SSA antibody and anti-Sm antibody were both evidently higher in the NPLE patients without seizure（P〈0.05）. The EEG and CT or MRI of brain was normal or mild non-specific changes. Conclusion： NPLE usually occured at the early and the active stage of SLE. The most common of neuropsychiatric manifestations of NPLE were seizures and headaches. SLE patients with elevated ESR, thrombocytopenia and cutaneous vasculitis and neuropsychiatric symptoms, should consider the possibility of NPLE. Anti SSA and anti Sm antibodies could be used as a reference index of NPLE patients with seizures.
出处
《临床皮肤科杂志》
CAS
CSCD
北大核心
2014年第11期654-656,共3页
Journal of Clinical Dermatology
关键词
神经精神性狼疮
临床分析
neuropsychiatric lupus erythematosus
clinical analysis
