双冲击疗法联合鞘内注射治疗重症狼疮脑病伴多系统损害的临床观察

目的:观察双冲击疗法联合鞘内注射治疗重症狼疮脑病(NPSLE)伴多系统损害的临床疗效.方法:对8例NPSLE伴多系统损害患者应用甲泼尼龙和环磷酰胺双冲击疗法联合鞘内注射治疗.甲泼尼龙500mg 5%葡萄糖注射液500ml静脉滴注冲击治疗,共3～5 d;第6天行环磷酰胺1.0 g 生理盐水250ml静脉滴注冲击治疗;甲氨蝶呤10 mg 地塞米松(DXM)10 mg 生理盐水3 ml鞘内注射.结果:8例患者经治疗后临床症状迅速缓解,其中6例狼疮脑病迅速控制,2例分别在4次和6次鞘内注射后缓解.结论:双冲击联合鞘内注射治疗重症狼疮脑病伴多系统损害的疗效显著.

Clinical Observation of Double-pulse Therapy Combined With Intrathecal Injection in Treating Severe Neuropsychiatric Systemic Lupus Erythematosus With Multi-system Injuries

Objective:To investigate the efficacy of doublepulse therapy combined with intrathecal injection in treating severe neuropsychiatric systemic lupus erythematosus(NPSLE)with multi-system injuries.Methods:Eight cases with NPSLE with multi-system injuries were received Methylprednisolone and Cyclophosphamide doublepulse therapy combined with intrathecal injection of MTX 10 mg and dexamethasone 10 mg.Methylprednisolone(MP)500 mg dissolved in 5% glucose 500 ml was dripped intravenously for 3 to 5 days.Cyclophosphamide(CTX)1.0 g dissolved in 0.9% sodium chloride solution injected intravenously after MP at the sixth day.Results:The clinical symptoms of 8 patients relieved soon after therapy.Six patients with NPSLE were controlled quickly,the other two patients relieved after 4 and 6 times' of intrathecal injection respectively.Conclusion:The efficacy of doublepulse therapy combined with intrathecal injection in treating severe NPSLE with multi-system injuries is prominent.