SLE伴颅内动脉瘤致右眼睑下垂一例  

Systemic lupus erythematosus complicated with right eyelid ptosis caused by intracranial aneurysm: a case report

作　　者：曹思曼 文军[2] 宋广梅 崔艳杰 乔洁 周毅[1] 朱丽花[1] Cao Siman;Wen Jun;Song Guangmei;Cui Yanjie;Qiao Jie;Zhou Yi;Zhu Lihua(Department of Rheumatology and Immunology,the First Affiliated Hospital of Jinan University,Guangzhou 510630,China)

机构地区：[1]暨南大学附属第一医院风湿免疫科,广州510630 [2]暨南大学附属第一医院神经外科,广州510630

出　　处：《新医学》2023年第1期75-79,共5页Journal of New Medicine

基　　金：广东省医学科学技术研究基金(A2018271);广东省自然科学基金博士启动项目(2017A030310456);暨南大学第一临床医学院科研培育专项基金项目(2018302)。

摘　　要：SLE是一种病因尚未完全阐明,累及全身多个器官系统的慢性弥漫性结缔组织病。SLE伴颅内动脉瘤并不多见,多见于有多年病史且疾病控制不佳的SLE患者,大多数患者无明显症状,部分患者以头痛、恶心或瘤体压迫颅神经引起相应症状为主要表现。该文报道一例初发SLE的47岁女性患者,在治疗过程中出现颅内动脉瘤,并压迫右侧动眼神经引起右眼睑下垂,经规范药物治疗联合介入手术,右眼睑下垂症状得以迅速改善。该例患者的诊治过程提示,当SLE患者出现头晕、头痛、呕吐或神经压迫症状时,要警惕颅内动脉瘤的可能性;一经确诊,应在积极、规范的药物治疗基础上及时行手术干预,进而避免患者出现动脉瘤破裂或颈动脉海绵窦瘘等严重并发症。Systemic lupus erythematosus(SLE) is a chronic connective tissue disease affecting multiple organ systems of the body, whereas the etiology of SLE has not been fully clarified. SLE complicated with intracranial aneurysm is rare, which is mostly seen in SLE patients who have been diagnosed for many years and the disease is uncontrolled. Most SLE patients complicated with intracranial aneurysm have no symptoms, while some patients present with headache, nausea or central nervous system symptoms caused by the aneurysm. Here, we reported a case of newly-diagnosed SLE complicated with the right eyelid ptosis caused by intracranial aneurysm compression of the right oculomotor nerve during treatment. After standard drug therapy combined with cerebral vascular interventional surgery, the right eyelid ptosis was rapidly mitigated. The diagnosis and treatment of this patient prompt that the possibility of intracranial aneurysm should be considered when SLE patients develop dizziness, headache, vomiting or nerve compression symptoms. Standard drug therapy combined with surgical intervention should be performed when the diagnosis is confirmed, aiming to prevent the incidence of severe complications, such as aneurysm rupture or carotid-cavernous fistula.

关 键 词：系统性红斑狼疮 颅内动脉瘤 动眼神经 眼睑下垂 

分 类 号：R593.2[医药卫生—内科学] R743[医药卫生—临床医学] R777.1