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目的:探讨神经精神性狼疮(NPLE)的临床特征、实验室检查情况和活动性评分。方法:回顾性分析25例.NPLE患者的临床资料,同时将160例非NPL.E患者设为对照组,比较两组患者的临床表现及实验室检查情况。根据有无癫痫发作将NPLE组分为两亚组,比较亚组间相关指标的差异。结果:SLE患者中NPLE患者占13.9%,且多发生在SLE的早期(前3年占68%)及活动期(SLEDAI 10分者占88%)。25例NPLE患者中癫痫发作(21.4%)、头痛(12.5%)和情绪障碍(12.5%)。NPLE患者常并发多系统损害(92%),以血液系统损害(68%)和狼疮性肾炎(44%)常见。NPLE组血沉增高、血小板减少及皮肤血管炎的发生率高于非NPLE组(P<0.05)。NPLE患者中癫痫发作组抗SSA抗体、抗Sm抗体阳性率显著高于无癫痫发作组(P<0.05)。NPLE患者脑电图、脑部CT、磁共振(MRI)检查多正常或轻度非特异性改变。结论:NPLE多发生在SLE的早期及活动期;NPLE神经精神学表现以癫痫发作及头痛常见;SLE患者出现血沉增高、血小板减少及皮肤血管炎并有神经精神症状时,应考虑NPLe的可能:抗SSA抗体及抗Sm抗体可作为NPLE患者癫痫发作的参考指标。
Objective: To investigate the clinical features, laboratory tests and activity scores of neuroleptic lupus (NPLE). Methods: The clinical data of 25 patients with NPLE were retrospectively analyzed. At the same time, 160 non-NPL.E patients were selected as the control group. The clinical manifestations and laboratory tests of the two groups were compared. According to the presence or absence of seizures, the NPLE group was divided into two subgroups and the differences between the relevant subgroups were compared. Results: SLE patients accounted for 13.9% of NPLE patients, and occurred in the early SLE (68% in the first three years) and active (SLEDAI 10% 88%). Twenty-five NPLE patients had seizures (21.4%), headache (12.5%), and mood disorders (12.5%). Patients with NPLE often have multiple system lesions (92%), common with hematologic (68%) and lupus nephritis (44%). NPLE group increased ESR, thrombocytopenia and skin vasculitis than non-NPLE group (P <0.05). The positive rate of anti-SSA antibody and anti-Sm antibody in seizure group was significantly higher than that in non-seizure group (P <0.05). NPLE patients with EEG, brain CT, magnetic resonance (MRI) examination of more than normal or mild non-specific changes. Conclusions: NPLE mostly occurs in the early and active stages of SLE. NPLE neuropsychiatric findings are common in epileptic seizures and headache. SLE patients with elevated ESR, thrombocytopenia and cutaneous vasculitis with neuropsychiatric symptoms should consider the possibility of NPLe: Anti-SSA antibodies and anti-Sm antibodies can be used as a reference for seizures in patients with NPLE.