神经精神狼疮26例临床分析
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Clinical Analysis on 26 SLE Patients with Neuro-Psychological Manifestations
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    摘要:

    了解神经精神狼疮(NPLE)的临床特征及治疗转归。方法 回顾1992~1998年在本院风湿科诊治的26 例神经精神狼疮的临床资料。结果 26例NPLE患者50%在起病1年内发病,有器质性脑病综合征11例,脑血管意外2例,癫 4例,狼疮性头痛2例,精神症状或精神病7例。19例重症NPLE中,12例给予甲基强的松龙冲击加免疫抑制剂治疗后10例 病情缓解,2例死亡;7例单用甲基强的松龙冲击治疗者4例缓解,3例死亡(P>0.05)。7例精神症状为主要表现者6例以强的 松<1 00mg/d剂量加抗精神病药物,均在2周至2个月内病情缓解。结论 对于重症NPLE应尽早给予糖皮质激素加免疫抑制 剂冲击治疗,而精神症状者常规剂量激素加抗精神病药物即有明显疗效。

    Abstract:

    To explore clinical features, treatment and prognosis of neuro psychological lupus erythe matosus (NPLE). Methods Clinical data of 25 SLE patients with neuro-psychoingical manifestations who were hospi talized in Department of Rheumatoingy of our hospital from year 1992 to 1998 were retrospectively summarized. Results In eilninal features, among 26 NPLE patients 13 cases occurred within one year after SLE onset, 11 cases pre seined organic eneephalopathy syndrome, 2 cases encephalin stroke, d cases epilepsy', 2 cases lupoid encephalodynia, 7 cases psychological manifestations or psychosis. In treatment, 12 of 19 servere NPLE patients were intravenously given methoprednisoinne plus immuno suppressive agent pulse dose, in which 10 cases remitted, 2 cases died; the other 7 cases were intravenously treated with methoprednisolone pulse dose alone, in which 4 cases remitted, 3 cases died, compared with the above, P>0. 05, whereas, 6 of 7 cases with psychological manifestations were administrated with oral prednisone, by dose of less than J 00 rog/d, plus anti-psychosis drugs, and then remitted within 2 weeks over 2 months. Conclusion Glucose cortico-steroids plus immuno-suppressive agent pulse dose treatment is efficient for severe NPLE patients and conventional dose glucose corticosteroids plus anti-psychosis drugs treatment is effective for NPLE patients with psychological manifestations.

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顾镭,柯瑶,汤建平,沈友轩,刘晓华,张缪佳.神经精神狼疮26例临床分析[J].南京医科大学学报(自然科学版),2000,20(03):

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