儿童神经精神性狼疮的研究进展

Progress in pediatric neuropsychiatric systemic lupus erythematosus

儿童神经精神性狼疮(NPSLE)是系统性红斑狼疮(SLE)的严重并发症,可发生于SLE病程的任何阶段,其可能的发病机制是多方面的,包括自身抗体的产生、微血管病变、鞘内前炎性因子的产生和过早的动脉粥样硬化等。其临床表现复杂多样,中枢神经系统症状在儿童常见,可以出现严重的反复发作性头痛、癫发作、脑血管意外及精神症状。综合运用血清学、脑脊液检查、神经影像学检查有助于NPSLE的诊断。治疗主要应用免疫抑制剂和对症处置。早期诊断、积极治疗可能有助于改善患儿的预后。

Pediatric neuropsychiatric systemic lupus erythematosus（NPSLE） is a serious complication of pediatric systemic lupus erythematosus（SLE）.It may occur at any stages of the disease.The pathogenic causes of NPSLE are likely to be multifactorial and may involve autoantibody production,microangiopathy,intrathecal production of proinflammatory cytokines and early-onset arteriosclerosis.Its clinical manifestations are complex and diversified.Symptoms of central nervous system are common in children,including repeated and paroxysmal headache,seizure,stroke and psychiatric symptoms.Comprehensive analysis of laboratory data of serum,cerebrospinal fluid and brain and spinal imaging examination can be helpful for the diagnosis of NPSLE.The management of patients with NPSLE consists of symptomatic and immunosuppressive therapies.Early diagnosis and active treatment may improve the prognosis of childhood NPSLE.