神经精神狼疮55例患者临床分析  

Clinical Analysis of Fifty five Patients with Neuropsychiatric Lupus

作　　者：林福安 赵婷 黄晓璐 陈宏浦 LIN Fuan;ZHAO Ting;HUANG Xiaolu;CHEN Hongpu(Department of Rheumatology,Zhangzhou Affiliated Hospital of Fujian medical University,Zhangzhou 363000,China)

机构地区：[1]福建医科大学附属漳州市医院风湿免疫科,福建漳州363000

出　　处：《中华灾害救援医学》2024年第3期277-280,共4页Chinese Journal of Disaster Medicine

摘　　要：目的探讨神经精神狼疮(Neuropsychiatric Systemic Lupus Erythematosus,NPSLE)的临床特点及联合鞘内注射地塞米松疗效分析。方法回顾性分析2020年1月至2022年12月福建医科大学附属漳州市医院收治的55例神经精神狼疮患者的神经系统表现、实验室检查、脑脊液检查和颅脑核磁共振检查特点,同时将患者根据治疗方法不同分成常规治疗组和常规治疗联合鞘内注射地塞米松组(联合治疗组),记录不同治疗组的疗效进行分析。结果常规治疗联合鞘内注射地塞米松的治疗组疗效要明显优于常规治疗组,有效率分别为93.55%和66.67%。随访1年,联合治疗组的复发率低于常规治疗组,生活质量高于常规治疗组(P<0.05);两组生存率差异无统计学意义(P>0.05)。结论神经精神狼疮属于狼疮的重症,诊断需结合临床症状、脑脊液检查、颅脑核磁共振检查等做出,激素和免疫抑制剂是基础治疗,联合鞘内注射地塞米松有助于提高疗效。Objective To explore the clinical characteristics of Neuropsychiatric Systemic Lupus Erythematosus(NPSLE)and the efficacy of combined intrathecal injection Dexamethasone therapy.Methods The neurological manifestations,laboratory examination,cerebrospinal fluid examination and cranial magnetic resonance examination of 55 patients with neuropsychiatric lupus admitted to Zhangzhou Hospital in Fujian Province from January 2019 to December 2019 were retrospectively analyzed,and the patients were divided into the conventional treatment group and the conventional treatment combined with intrathecal injection group(the combined group)according to treatment methods.The therapeutic effects of different treatment groups were recorded and analyzed.Results Epilepsy is the most common clinical manifestation of neuropsychiatric lupus,followed by cerebral infarction,headache,and mental disorders;with 80%showing severe activity,60%showing abnormalities in routine cerebrospinal fluid examination,and 29.1%showing abnormal signals on brain MRI.The therapeutic effect of the combined intrathecal hormone injection group was significantly better than that of the conventional treatment group,with effective rates of 93.55%and 66.67%,respectively.At 1 year follow-up,the relapse rate and QOL score of the combined group were lower than those of the control group(P<0.05),and the difference of survival rate was not significant(P>0.05).Conclusion Neuropsychiatric lupus is a serious disease.The diagnosis should be made in combination with clinical symptoms,cerebrospinal fluid examination,brain MRI,and etc.Hormone and Immunosuppressive drug are basic treatment,and combined intrathecal hormone injection is helpful to improve the efficacy.

关 键 词：红斑狼疮 系统性 注射 地塞米松 

分 类 号：R593.24[医药卫生—内科学]