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全身性红斑狼疮(SLE)患者1/4～3/4可见到精神及神经症状,并成为SLE诊断标准之一。其表现为抽搐、精神病、颅神经麻痹等,而横贯性或广泛的脊髓损害则少见。其共同病理改变是基于血管炎及血管损害的循环障碍引起的脊髓变性、坏死。用类固醇制剂有效,并推荐早期使用大剂量。本文报告1例在第1次发生横贯性脊髓损害时,24小时内投予大剂量本药后症状减轻,病情恢复,但第2次急性发作后症状迅速恶化、死亡。患者33岁,女。家族史、既往史无特殊。21岁时曾发热,关节痛,诊断为胶原疾病并接受治疗。24岁时有发热和抽搐发作。32岁时有发热和精神症状,并入精神科治疗,病情减轻。在入院前1天觉心窝部疼痛,下肢麻木感,次日清晨出现双下肢瘫痪和排尿障碍而入院。检查触觉正常,胸_7,以下痛觉消失,用类固醇制剂100mg/d、尿激酶43,000U/d后缓慢恢复。约6个月后又发热,体温38℃,呼吸困难,手指
One in four to three-quarters of patients with systemic lupus erythematosus (SLE) can develop mental and neurological symptoms and become one of the diagnostic criteria for SLE. Its performance is convulsions, mental illness, cranial nerve paralysis, etc., while the traversing or extensive spinal cord injury is rare. Its common pathological changes are based on the spinal cord degeneration and necrosis caused by circulatory disorders of vasculitis and vascular damage. Use steroid formulations effective, and recommended early use of large doses. This article reports 1 case of traumatic spinal cord injury in the first time, within 24 hours after the administration of large doses of the drug reduce the symptoms, the condition recovered, but after the second acute attack the symptoms deteriorated rapidly and died. Patient 33 years old, female. Family history, no previous history. 21 years old had fever, joint pain, diagnosis and treatment of collagen disease. 24-year-old fever and seizures. Fever and psychiatric symptoms at 32 years of age, merged into psychiatric treatment, condition reduced. One day before admission, he felt a pain in his littoral part and a feeling of numbness in the lower limbs. Paralysis of the lower extremities and voiding dysfunction appeared on the morning of the next day and were admitted to the hospital. Check the normal touch, chest _7, the following pain disappeared with steroid preparations 100mg / d, urokinase 43,000U / d after a slow recovery. About 6 months later fever, body temperature 38 ℃, breathing difficulties, fingers