神经精神性狼疮临床特征与疗效分析

Analysis on clinical features and curative effect in patients with neuropsychiaric systemic lupus erythematosus

目的探讨神经精神性狼疮的临床特征与疗效。方法对60例伴神经精神性狼疮的系统性红斑狼疮患者临床表现,多项免疫学指标,并发症和伴发症及疗效进行回顾性分析。结果神经精神性狼疮的临床表现中以癫痫发作出现几率最高(28.3%),其次为狼疮头痛(23.3%)、意识障碍(18.3%)。并发症和伴发症阳性率在神经精神性狼疮组(85%)分布明显高于非神经精神性狼疮组(32%),且以狼疮肾炎最高(58%)。其余各项指标组间比较差异均无统计学意义。甲强龙加环磷酰胺冲击疗法病情缓解率(80%)明显高于单用甲强龙冲击疗法(51%)。结论神经精神性狼疮临床表现多样,以癫痫发作、狼疮头痛及意识障碍最多见。系统性红斑狼疮患者有并发症和伴发症可提示神经精神性狼疮的发生几率增加。激素联合免疫抑制剂冲击治疗疗效好。

Objective To explore the clinical features and treatment effect in patients with neuropsychiaric systemic lupus erythematosus. Methods The retrospective analysis about clinical manifestations, a number of immunological indicators, complications and with complications and treatment were carried out in 60 cases with neuropsychiaric systemic lupus erythematosns （NPSLE）. Resluts The highest incidence was seizures （28.3%） among the clinical manifestations of neuropsychiatric lupus; this was followed by lupus headache （23.3%）, disturbance of consciousness （18.3%）. The number of complications and with complications in NPSLE group （85%） was higher than that of in non - NPSLE group （32%）, the proportion of the highest is lupus nephritis （58%）. Compared the other immunologic parameters, there was no significant difference between the two groups. The remission rate in methylprednisoione and cyclophsphamide pulse therapy group （80%） was higher than that of in methylprednisolone pulse therapy group （51%）. Conclusion Neuropsychiatric lupus clinical manifestations are varied incude seizures, lupus headache and disturbance of consciousness. Complications and with complications can occur in patients with systemic lupus erythematosus prompted neuropsychiaric lupus increase the probability. The therapy effective of hormone and immunosuppressant is much better.