原发性干燥综合征神经系统损害21例临床分析  

Neurological dysfunctions in 21 patients with primary Sjogren syndrome

作　　者：袁春云[1] 李蜀渝[1] 肖波[1] 马艳[1] 李艺[1] 唐薇婷[1] 杨利[1] 

机构地区：[1]中南大学湘雅医院神经内科,湖南长沙市410008

出　　处：《国际神经病学神经外科学杂志》2010年第1期9-11,共3页Journal of International Neurology and Neurosurgery

摘　　要：21例原发性干燥综合征(PSS)患者,中老年女性占95%,有眼干、口干症状者16例,以神经系统症状首发14例。神经系统损害主要为脑损害15例,呈脑梗死型,以皮质下及脑室周围白质为主,脊髓损害5例,均合并脑梗死,以上胸段脊髓为主;周围神经损害5例;低钾性周期性瘫痪1例。神经系统损害症状可在眼干、口干症状前或后。对中老年女性出现不能用其他疾病解释的神经肌肉症状,应注意询问眼干、口干病史,进行相关的检查,以利早期诊断。To investigate the clinical features of neurological dysfunctions in primary Sjogren syndrome （PSS）, 21 patients who were diagnosed with PSS associated with neurological dysfunctions in Xiangya Hospital from 2002 to 2009 were retrospectively studied. Ninety-five percent of the patients are middle-aged women （38-65 years old）. The neurological symptoms occurred before or after the symptoms of oral and ocular dryness. Fifteen patients had center nervous system （CNS） disorders, which were mostly multifocal. All of the 15 patients had cerebral infarction and presented with white matter lesions on MR imaging. Among the 15 patients, 5 had spinal cord involvement： three of them mimicked the symptoms of relapsing-remitting multiple sclerosis （MS）; while 2 of them resembled neuromyelitis optica （NMO）. In addition, 5 patients’ symptoms involved peripheral nervous system （PNS） that presented with asymmetric sensory symptoms and 1 patient had hypokalemic paralysis combined with renal tubule acidosis. Anti-Ro/SSA and anti-La/SSB antibodies were positive in 13 patients. Hence clinical manifestations of neurological dysfunctions are multiplex in PSS patients, and both CNS and PNS can be involved. Accordingly, when middle-aged women manifest neuromuscular symptoms that can not be explained by other diseases, it is necessary to think about the possibility of PSS and pay attention to the occurrence of possible symptoms such as oral and ocular dryness.

关 键 词：原发性干燥综合征 神经系统损害 周围神经系统 

分 类 号：R593.2[医药卫生—内科学]