神经精神性狼疮脑电图及临床分析

目的通过脑电图检测和临床转归，观察甲基泼尼松龙和环磷酰胺单剂及联合冲击治疗神经精神性狼疮的疗效和不良反应。方法36例神经精神性狼疮患者随机分为3组，分别应用甲基泼尼松龙（A组）、环磷酰胺（B组）、甲基泼尼松龙联合环磷酰胺（c组）冲击治疗；动态观察脑电图改变、SLE疾病活动指数、血清补体C3、IgG含量及ANA、抗ds—DNA抗体、抗Sm抗体的转阴率，评估其疗效和不良反应。结果（1）治疗6个月后显效的15例患者脑电图完全恢复正常者13例；好转的11例患者中4例恢复正常；无效的10例患者轻度异常2例，中度异常4例，重度异常2例。（2）治疗后1、6个月后3组SLE疾病活动指数降低、血清补体C3、IgG含量及ANA、抗ds—DNA抗体、抗sm抗体的转阴率均增高，较治疗前有显著性差异（均P〈0．01），而且C组的上述指标变化显著优于A、B两组（P〈0．05或0．01）；（3）治疗1、6个月后，C组显效率（40％／60％）明显高于A组（14％／28％）、B组（17％／42％），P〈0．05或0．01；A、B两组显效率无显著性差异（P〉0．05）。结论甲基泼尼松龙和环磷酰胺联合冲击治疗神经精神性狼疮疗效优于单剂冲击治疗．脑电图改变与临床改变呈正相关。

The Electroencephalogram and Clinical Analysis in Neuropsychiatric Lupus Erythematosus Patients

Objective To investigate the effect and adverse reaction of Methyllprednisolone and Cyclophosphamide as single-method therapy and combination pulse therapy on neuropsychiatric lupus erythematosus patients by electroencephalogram and clinical outcome. Methods 36 patients were randomly divided into three groups：Methyllprednisolone group （group A）, Cyclophosphamide group （group B）,both Methyllprednisolone and Cyclophosphamide group （group C）. The electroencephalogram changes, systematic lupus erythematosus activity index, serum complement C3, IgG level and antibody reversing ratio of ANA, anti-dsDNA antibody and anti-SM antibody were dynamic detected to evaluate the therapeutic effect and adverse reaction. Results （1）After six months,the electroencephalogram of 13 patients completely recovered in 15 markedly effective patients,4 cases completely recovered in 11 improved patients, there were 2 mild abnormal, 4 moderate abnormal and 2 severe abnormal patients in 10 inefficient patients. （2）After one month and six months, respectively, systematic lupus erythematosus activity index decreased and other serum index increased significantly（P〈 0.01 ）, furthermore,the changes were more significant in group C than in group A and B （P 〈 0.05, P 〈 0.01 ）. （3）After one month and six months, respectively, markedly effective rate in group C （40%/60%） was higher than group A（ 14% / 28%）（P〈 0.05,P〈 0.01 ）,no significant difference was found between group A and B（P〉 0.05）. Conclusion The curative effect of combination pulse therapy both Methyllprednisolone and Cyclophosphamide was better than single-method therapy,the electroen- cephalogram changes were positively related with clinical outcomes.