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目的 了解神经精神狼疮 (NPL E)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 2 6例神经精神狼疮的临床资料。结果 2 6例 NPL E患者 5 0 %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 ,癫痫 4例 ,狼疮性头痛 2例 ,精神症状或精神病 7例。 19例重症 NPL E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 .0 5 )。 7例精神症状为主要表现者 6例以强的松 <10 0 mg/ 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 NPL E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。
Objective To understand the clinical features and treatment outcome of neuropathic lupus (NPL E). Methods The clinical data of 26 neuropathic lupus patients diagnosed and treated in our department from 1992 to 1998 were retrospectively reviewed. Results 50% of 26 patients with NPL E developed disease within 1 year of onset. There were 11 cases of organic encephalopathy syndrome, 2 cases of cerebrovascular accident, 4 cases of epilepsy, 2 cases of lupus headache and 7 cases of psychotic symptoms or psychosis. In 19 cases of severe NPL E, 10 cases were relieved after 12 cases were treated with methylprednisolone impact and immunosuppressive agents, and 2 cases died. Among the 7 cases treated with methylprednisolone shock alone, 4 cases were relieved and 3 Cases of death (P> 0.05). Seven patients with psychotic symptoms as the main performance 6 patients with prednisone <10 0 mg / d plus antipsychotics, were in 2 weeks to 2 months to remission. Conclusion Severe NPL E should be given as soon as possible glucocorticoid and immunosuppressive shock therapy, and psychiatric symptoms of conventional dose of hormone plus antipsychotic drugs that have a significant effect.