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目的 :探讨系统性红斑狼疮神经系统并发症 ( NSLE)的临床特征、发生的免疫病理机制及有效的检查手段。方法 :分析 2 1例 NSLE患者的临床、免疫学、电生理及影象学表现。结果 :中枢神经系统病变最多见 ,临床表现与病变部位及性质相符合 ;SLE性脑病、脑膜脑炎、颅内高压、横贯性脊髓炎及毛霉菌病鼻脑型的脑 /脊髓的CT/MRI基本正常 ,多发性脑梗死及脑脓肿的 CT/MRI示多病灶 ,其中 1例多发性脑梗死的 DSA示右侧颈内动脉闭塞 ;仅 2例检查了脑脊液的寡克隆区带及 Ig G合成率 ,均为异常。周围神经和肌肉系统病变各 4例和 6例。结论 :NSLE常见 ,致残率高 ,临床表现多样 ,电生理、影象学、神经、肌肉活检、脑脊液免疫学及病原学检查有很高的诊断价值。
Objective: To investigate the clinical features of neurological complications (NSLE) in systemic lupus erythematosus (SLE), the mechanism of immunopathology and effective examination methods. Methods: Clinical, immunological, electrophysiological and imaging findings of 21 NSL patients were analyzed. Results: The most common lesions of the central nervous system, clinical manifestations consistent with the location and nature of lesions; SLE encephalopathy, meningoencephalitis, intracranial hypertension, transverse myelitis and Mucormycosis of brain / spinal cord CT / MRI Basal normal, multiple cerebral infarction and brain abscess CT / MRI showed multiple lesions, of which 1 case of multiple cerebral infarction DSA showed right internal carotid artery occlusion; only 2 cases examined cerebrospinal fluid oligoclonal band and Ig G synthesis Rate, are abnormal. Peripheral nerve and muscle system lesions in 4 cases and 6 cases. CONCLUSIONS: Common NSILs have a high morbidity rate and diverse clinical manifestations. Electrophysiology, imaging, nerve, muscle biopsy, immunological and cerebrospinal fluid immunological tests have high diagnostic value.