神经精神狼疮的临床特征

Characteristic Manifestations of Neuropsychiatric Systemic Lupus Erythematosus

目的探讨神经精神狼疮(NPSLE)的临床、辅助检查特点。方法回顾性分析198例北京协和医院1999～2003年收治并确诊为NPSLE患者的临床表现及血清学、腰穿、头颅核磁及脑电图等辅助检查。结果系统性红斑狼疮累及神经系统最常表现为头痛、精神障碍、癫痫、卒中、急性意识模糊状态,其中52例行头颅核磁检查,34例异常(包括卒中发作);48例仅出现头痛的患者,脑脊液压力升高及脑脊液蛋白升高比例与其他NPSLE比较差异有显著性(P<0.05)。结论神经精神狼疮主要根据临床表现诊断,头颅核磁及脑脊液检查对中枢性狼疮诊断的帮助较大,但目前仍缺乏特异性较强的辅助检查手段。

Objective To investigate the characteristic lupus erythematosus （NPSLE） in clinical practice. Methods to 2003 in Peking Union Medical College Hospital, were the results of accessory examination such as serology, lumbar manifestations of neuropsychiatric systemic A total of 198 NPSLE cases from 1998 included. Their clinical manifestations and puncture, head magnetic resonance imaging, and electroencephalogram were analyzed. Results The most frequent manifestations of the NPSLE included： headache, psychiatric disorder, seizure, stroke, and acute confusional state. Fifty-two patients took head magnic resonance imaging, and 34 of them showed abnormal, including stroke attack. Among 48 patients who only had a complaint of headache, the increase of intracranial pressure and cerebral spinal fluid protein was significantly higher than other NPSLE syndromes （P 〈 0.05）. Conclusion Diagnosis of NPSLE was mainly based on its clinical manifestations. Head magnetic resonance imaging and cerebral spinal fluid examination may be helpful. More specific accessory examinations require further development.