神经精神性狼疮患者实验室指标及临床症状研究

Study on the laboratory indexes and clinical symptoms of patients with neuropsychiatric systemic lupus erythematosus

目的分析神经精神性红斑狼疮(neuropsychiatric systemic lupus erythematosus,NPSLE)患者的实验室指标和临床症状,为NPSLE患者的病情判断和个体化治疗提供依据.方法对确诊的136例NPSLE和146例非神经精神性系统性红斑狼疮(non-NPSLE)患者的相关实验室检测指标及临床症状进行对比分析.结果NPSLE组的C反应蛋白、中性粒细胞数、中性粒细胞比例及抗核抗体(antinuclear antibodies,ANA)、乙肝病毒DNA拷贝数高于non-NPSLE组(P<0.05);而血清白蛋白、红细胞沉降率、免疫球蛋白G、免疫球蛋白E、淋巴细胞数、淋巴细胞比例在NPSLE组低于non-NPSLE组(P<0.05).NPSLE组患者系统性红斑狼疮疾病活动度评分(systemic lupus erythematosus disease activity index,SLEDAI)显著高于non-NPSLE组(P<0.05),除神经精神系统表现外,低补体(89.71%)、24h蛋白尿(59.50%)和发热(58.82%)等临床症状也较为常见.结论血清ANA阳性而淋巴细胞计数及比例降低与NPSLE患者活动度相关.乙肝病毒感染可能与NPSLE有关,在临床诊治中应予以重视.

Objective To analyze the laboratory indexes and clinical symptoms of patients with neuropsychiatric systemic lupus erythematosus(NPSLE),so as to provide the basis for the condition judgment and individual treatment of NPSLE patients.Methods The laboratory indexes and clinical manifestations of 136 cases of NPSLE and 146 cases of non-NPSLE were compared and analyzed.Results The distribution of C-reactive protein,neutrophils,neutrophil rate,antinuclear antibodies(ANA)and hepatitis B virus DNA copies in NPSLE group were higher than those in non-NPSLE group(P<0.05),while the distribution of serum albumin,erythrocyte sedimentation rate,immune globulin G,and immune globulin E concentrations,lymphocytes and lymphocyte ratio were lower than those in non-NPSLE group(P<0.05).The systemic lupus erythematosus disease activity index(SLEDAI)score in NPSLE group was significantly higher than in that non-NPSLE group(P<0.05).In addition to the neuropsychological manifestations,the clinical symptoms of low complement(89.71%),24 hours proteinuria(59.50%)and fever(58.82%)are also common in NPSLE group.Conclusions The activity of NPSLE patients was related to the decrease of lymphocyte count and proportion while ANA was positive in serum.Hepatitis B virus infection may be related to NPSLE,which should be paid more attention in clinical diagnosis and treatment.