神经精神狼疮磁共振成像表现实验室检查与预后的关系  

MRI study of cerebral lesions and analysis of laboratory examination and prognosis of patients with neuropsychiatric systemic lupus erythematosus

作　　者：周广宇[1] 周立祥[4] 李叶[5] 金玲[2] 张文龙[3] 尹敏[1] 

机构地区：[1]吉林大学中日联谊医院肾病内科,长春130033 [2]吉林大学中日联谊医院检验科,长春130033 [3]吉林大学中日联谊医院血液内科,长春130033 [4]吉林大学第一医院神经创伤外科 [5]吉林大学第一医院放射线科

出　　处：《中华风湿病学杂志》2012年第10期697-700,共4页Chinese Journal of Rheumatology

基　　金：吉林省科技厅国际科技合作项目（20100738）

摘　　要：目的分析神经精神狼疮（NPSLE）患者头部磁共振成像（MRI）表现、实验室检查及预后，探讨MRI表现、自身抗体与NPSLE预后的关系。方法将31例诊断明确、资料完整的NPSLE患者分为存活组（24例）和死亡组（7例），分析MRI表现、实验室检查及其与预后的关系。采用，检验和Speam。。等级相关分析进行统计学处理。结果死亡组局灶性病变比例（86％）明显高于存活组（13％）（P〈0．01）；死亡组与存活组脑干病变比例（18％与0）和基底节区病变数比例（29％与12％）差异均有统计学意义（P〈0．01，P〈0．05）；死亡组抗核糖体P蛋白抗体阳性率（43％）显著高于存活组（29％）（P〈0．05）；局灶性病变者抗心磷脂抗体（ACL）阳性率（56％）显著高于弥漫性病变（35％）（P〈0．05）；自身抗体与MRI病变部位无相关性。结论NPSLE患者头部MRI表现和自身抗体具有一定相关性，二者可用于判断预后。Objective To investigate the magnetic resonance imaging （MRI） characteristics of cerebral lesions, laboratory data and prognosis of patients with neuropsychiatric systemic lupus erythematosus （NPSLE） and evaluate the correlation of MRI findings, autoantibodies and prognosis of NPSLE. Methods Thirty-one patients with NPSLE admitted during Jan 1998 to Oct 2011 were enrolled into this study, including 2 males and 29 females. MR1 characteristics of cerebral lesions, laboratory data and clinical outcomes were retrospectively analyzed.）（a-test and Spearman＇s correlation were used for statistical analysis. Results Cranial MRI scans on admission were abnormal in 27 （87%） of the 31 patients, among which 17 cases showed diffuse manifestations, 9 cases showed focal lesions in brain and 1 case showed brain atrophy. The percentage of cases with focal lesions in the dead group （86%） was significantly higher than that of the survival group （13%） （P〈0.01）, while the percentage of diffuse lesion cases was significantly lower in dead group （P〈0.01）. Although the mean lesion numbers in the dead group were fewer compared with the survival group, lesion numbers in brainstem （18%） （P〈0.01） or basal ganglia （29%） （P〈0.05） were much more in the dead group. The positive rate of anti-ribosomal P protein antibodies shown in the dead group （43%） was markedly higher than that in the survival group （29%） （P〈0.05）. The positive rates of ACL in cases with diffuse lesions and cases with focal lesion were higher compared with cases showing normal MR images （P〈0.01）. Furthermore, the positive rate of anticardiolipin antibodies （ACL） in cases with focal lesions （56%） were higher than cases with diffuse lesion （35%） （P〈0.05）. There was no correlation between the seven types of autoantibodies and lesion locations such as basal ganglia, subcortical white matter, anterior and posterior horn of lateral ventricle, semiovale center, cerebral cortex, brainstem a

关 键 词：狼疮血管炎 中枢神经系统 磁共振成像 实验室 预后 

分 类 号：R593.241[医药卫生—内科学]