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目的探讨神经精神性狼疮的临床表现、诊断、治疗。方法对28例神经精神性狼疮患者的临床资料进行回顾性分析。结果28例患者中发现8种神经精神性狼疮,以头痛最常见,其次是癫痫、脑血管病,可同时出现2种或2种以上神经精神症状,脑脊液、脑电图检查无特异性,脑脊液检查对排除感染性疾病有重要意义,MRI比CT更敏感,可发现微小的病变及脱髓鞘病变。结论NPSLE临床表现复杂多样,在排除感染、药物、肾功能不全、电解质紊乱、精神病等疾病引起的神经精神症状后,早期给予大剂量甲强龙冲击治疗及免疫抑制剂的应用,可减少死亡率,提高患者的生存质量。
Objective To investigate the clinical manifestations, diagnosis and treatment of neuropathic lupus. Methods The clinical data of 28 patients with neuropathic lupus were retrospectively analyzed. Results Eight neuropsychiatric lupus were found in 28 patients, the most common were headache, followed by epilepsy and cerebrovascular disease. Two or more neuropsychiatric symptoms were found at the same time. Cerebrospinal fluid and EEG were not specific. Cerebrospinal fluid Check on the exclusion of infectious diseases of great significance, MRI is more sensitive than CT, can be found in small lesions and demyelinating lesions. Conclusions The clinical manifestations of NPSLE are complex and diverse. The early application of high-dose methylprednisolone and immunosuppressive agents after elimination of neuropsychiatric symptoms caused by diseases such as infection, drugs, renal insufficiency, electrolyte disorders and psychosis can reduce the mortality rate , Improve the quality of life of patients.