神经精神狼疮26例临床分析

目的 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，癫痫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

Clinical Analysis on 26 SLE Patients with Neuro-Psychological Manifestations

Objective To explore clinical features, treatment and prognosis of neuro psychological lupus erythematosus (NPLE) Methods Clinical data of 26 SLE patients with neuro psychological manifestations who were hospitalized in Department of Rheumatology of our hospital from year 1992 to 1998 were retrospectively summarized Results In clinical features, among 26 NPLE patients 13 cases occurred within one year after SLE onset, 11 cases presented organic encephalopathy syndrome, 2 cases encephalic stroke, 4 cases epilepsy, 2 cases lupoid encephalodynia, 7 cases psychological manifestations or psychosis In treatment, 12 of 19 servere NPLE patients were intravenously given methoprednisolone 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 100 mg/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