儿童系统性红斑狼疮神经精神症状的研究（一）

Neuropsychiatric symptoms in Chinese children with systemic lupus erythematosus

目的通过分析儿童系统性红斑狼疮（SLE）神经精神症状的发病情况、临床及实验室表现、治疗等，探讨中国儿童神经精神性狼疮（NPSLE）的发病特点。方法回顾性研究1990-2006年诊断为SLE的62例中国儿童SLE患者。收集神经精神症状发病时的性别、年龄、病程、临床表现、实验室检查、影像学检查、治疗等资料，并与其他研究结果相对比。结果19例（31％）患者被诊断为NPSLE，共发生症状21次；最常见的神经精神症状是认知障碍（48％）、癫痫（43％）和头痛（29％）。单光子发射计算机断层成像（SPECT）的表现异常率达80％。86％的患者接受了甲泼尼龙治疗；大部分（74％）患者无神经精神系统后遗症。结论中国儿童SLE的神经精神症状是常见的，其发病特点与其他种族的报道有所不同；SPECT与MR是诊断NPSLE较敏感的辅助检查；儿童NPSLE的预后良好。

Objective To define the clinical characteristics of NPSLE in Chinese children by analyzing their demographic data, clinical manifestations, laboratory parameters and treatment. Methods Sixty- two children with SLE who were diagnosed between 1990 and 2006 were retrospectively reviewed. The demographic data, clinical manifestations, laboratory parameters, imaging and treatment were analyzed. The syndromes were compared with those reported in other studies. Results Nineteen （31%） SLE patients with 21 NP events were identified. The most common NP manifestations were cognitive dysfunction （48%）, seizure disorder （43%） and headache （29%）. The abnormality percentage of SPECT was 80%. 86% patients received MP pulses therapy. Most （74%） patients recovered without long-term neurological complications. Conclusi NP symptoms are common in Chinese children with SLE, however,the prese-ntations are different from that reported in other studies. SPECT and MR are sensitive tests for NPSLE. The prognosis of NPSLE in our series is favorable.