系统性血管炎神经系统受累

Nervous system injury in systemic vasculitis

系统性血管炎(systemic vasculitis, SV)神经系统受累包括中枢神经系统(central nervous system, CNS)损害和周围神经系统(peripheral nervous system, PNS)损害,是该类疾病预后不良的主要因素。其中,大动脉炎、巨细胞动脉炎、白塞病和抗中性粒细胞胞浆抗体(ANCA)相关性血管炎的神经系统受累尤其值得关注。在治疗上除了常规的糖皮质激素联合免疫抑制剂外,生物制剂如IL-6受体单克隆抗体、抗TNF-α单克隆抗体和抗CD20单克隆抗体也显示了确切疗效。

Systemic vasculitis can cause nervous impairments including central neuropathies and peripheral neuropathies,which seriously affect the prognosis.Neurological involvement of Takayasu arteritis, giant cell arteritis, Behcet′s syndrome and ANCA-associated vasculitis is of particular concern. In addition to conventional corticosteroids combined with immunosuppressants, some biological agents such as IL-6 receptor monoclonal antibody, anti-TNF-α monoclonal antibody,and anti-CD20 monoclonal antibody have also shown definite efficacy in the treatment of SV with neurological involvement.