神经精神性狼疮临床资料分析

目的探讨神经精神性狼疮的临床特点。方法以神经精神性狼疮或狼疮脑病为检索词,检索2000年~2006年国内公开发表的中文文献,选取其中有关临床分析及诊断的文献进行临床分析。结果神经精神性狼疮发生率占系统性红斑狼疮患者的15.1%,男女性别比约为1∶12,平均年龄31岁。神经精神症状以头痛(40.4%),癫痫发作(32.9%),意识障碍(21.8%),精神行为异常(12.8%)最多见;其他临床症状有发热(62.2%),关节疼痛(46.0%),面部红斑或皮肤损害(34.7%),肾损害(20.7%);脑电图约61%异常,颅脑CT有45.8%局灶或弥漫异常,MRI有66.7%弥漫性异常;抗核抗体阳性率49.2%,抗双链DNA阳性率33.4%。结论神经精神性狼疮以青年女性多见,常累及全身多系统和器官,诊断主要依据临床表现,影像学、血清抗体检查有一定参考价值,但特异性不高。

Mata analysis of neuropsychiatric manifestation in system ic lupus erythematosus

Objective To summarize neuropsychiatric manifestation in system ic lupus erythematosus. Methods With "neuropsychiatric system ic lupus erythematosus, NPSLE"as searth words, the related Chinese literatures published (2000~2006) were retrieved. A mata analysis was carried out. Results The incidence of NPSLE was 15.1% in SLE patients, the male to female ratio was 1 : 12, and the average age was 31 years. The most frequent brain damage were headache (40.4%), epilepsy or seizure disorder (32.9%), confusion state (21.8%), mental and behavior disorders (12.8%). The clinical manifestations of NPSLE were mainly febrile (62.2%), arthralgin (46.0%), butterfly erythema (34.7%) and kidney damage (20.7%). 61% patients were abnormal in EEG examination, abnormal CT sign were seen in 45.8% cases and that of MRI were 66.7%. The positive examination were antinuclear antibody (49.2%), anti-double strand DNA antibody (33.4%). Conclusion It was more common in young female who occurred NPSLE, the damage was extensive. Diagnosis of NPSLE was mainly based on its clinical manifestations, though head magnetic resonance imaging and antibody examination was not specific accessory examination, they may be help on diagnosis.