并发神经精神狼疮的儿童狼疮肾炎34例临床分析

Clinical Features in 34 Children-onset Patients with Neuropsychiatric Systemic Lupus Erythematosus and Nephritis Lupus

目的:分析并发神经精神性狼疮(NPSLE)的儿童狼疮性肾炎(LN)患者的临床特点。方法:对122例首次诊断为NPSLE合并LN的住院患者进行回顾性研究,收集其临床资料,比较儿童起病组(n=34)与成年起病组(n=88)的临床特点,包括:性别、系统性红斑狼疮(SLE)的病程、临床表现、实验室检查等。结果:儿童起病组SLE病程较成年起病组短(P<0.05);儿童起病组NPSLE以痫性发作为主(70.6%),而成年起病组以精神症状为主(52.3%),两组间存在显著性差异。成年起病组发生白细胞减少的比例明显高于儿童起病组(P<0.05)。结论:儿童起病的NPSLE合并LN患者的SLE病程、NPSLE临床类型、发生白细胞减少的比例与成年起病者不同,对不同年龄起病的NPSLE合并LN患者应给予不同的治疗策略。

Objective：To elevate clinical features of childhood-onset patients with neuropsychiatric systemic lupus erythematosus （NPSLE） and nephritis lupus （LN）. Methods：Medical records of 122 resident patients diagnosed as NPSLE with LN for the first time were reviewed and classified into two groups according to their ages at disease presentation. Among the patients studied, 34 were childhood onset, 88 were adult onset. We then examined clinical features such as gender, duration of systemic lupus erythematosus （SLE）, clinical manifestations and laboratory tests. Results： The study revealed significantly shorter duration of SLE （P 〈 0.05）, higher rates of seizure （70.6% VS. 34.1%, P 〈 0.05）, lower incidence of psychosis （23.5% VS. 52.3%,P 〈 0.05） and leucopenia （14.7% VS. 35.2%, P 〈 0.05） in childhood-onset patients. Conclusions： Age at onset has an impact on NPSLE with LN disease status , such as duration of SLE , NPSLE manifestations and leucopenia , and should be considered in the treatment strategies for patients with neuropsychiatric SLE and nephritis lupus.