中华皮肤科杂志 ›› 2004, Vol. 37 ›› Issue (1): 5-7.

• 论著 • 上一篇    下一篇

系统性红斑狼疮患者中枢神经系统损害的临床表现和脑脊液改变

梅焕平1, 李向红4, 唐福林3, 吕芙蓉2   

  1. 1. 南京医科大学第一附属医院风湿免疫科, 210029;
    2. 南京医科大学第一附属医院儿外科, 210029;
    3. 北京协和医院风湿免疫科;
    4. 赤峰市第三医院内二科
  • 收稿日期:2003-03-13 出版日期:2004-01-15 发布日期:2004-01-15

Clinical Features and CSF Changes of SLE Patients with Central Nerve System Involvement

MEI Huan-ping1, LI Xiang-hong4, TANG Fu-lin3, LÜ Fu-rong2   

  1. Department of Rheumatology, First Affiliated Hospital of Nanjing Medical University. Nanjing 210029, China
  • Received:2003-03-13 Online:2004-01-15 Published:2004-01-15

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摘要： 目的 总结系统性红斑狼疮(SLE)患者中枢神经系统损害(CNS-SLE)的临床表现,观察脑脊液(CSF)的变化,探讨CSF在SLE脑病诊断中的意义。方法 收集住院确诊的CNS-SLE患者120例,记录临床表现、CSF压力、蛋白定量、糖定量、氯化物、细胞数、血糖等指标,分析临床表现及CSF检测各指标的变化。结果 临床表现中以头痛最为常见占38.3%,以后依次为意识障碍、抽搐及癫痫发作、精神病样反应、呕吐、偏瘫、情感异常、烦躁不安、记忆力下降、言语不清,构音困难者占4.16%。磁共振成像(MRI)检查阳性率60.0%,而计算机断层扫描(CT)为33.3%,前者高于后者(P<0.05)。CSF检查表现平均CSF压力(1.85±0.80)kPa,蛋白定量(811.4±708.6)mg/L,细胞数(88.6±448.3)×106/L,而糖定量及糖/血糖比值接近正常范围。结论 CNS-SLE临床表现多样化,MRI检查阳性率高于CT检查。CSF改变中以压力升高、蛋白定量升高、细胞计数增加为突出。

关键词: 中枢神经系统疾病, 实验室技术和方法, 红斑狼疮,系统性

Abstract: Objective To study the clinical features of SLE patients with central nerve system involvement(CNS-SLE) and investigate the significance of cerebrospinal fluid (CSF) change in diagnosis of CNS-SLE. Methods One hundred and twenty SLE in-patients with CNS involvement were collected. The clinical manifestations and CSF test (including protein, sugar, Cl, and cell count) results in these patients were analyzed. Results Headache was the most common symplom in 38.3% of CNS-SLE patients. Other common manifestations were acute confusion, seizure, psychosis, vomiting, hemiplegia, memory decrease, dysphrasia in 4.16% of CNS-SLE. MR imaging provided more sensitive modality for the diagnosis (in 60.0%) of CNS-SLE than that of CT (in 33.3%). High CSF pressure was the most common abnormality (mean 1.85±0.80 kPa). Mean protein quantity of CSF was 811.4±708.6 mg/L, higher than that in normal subjects. Mean cell count in CSF was (88.6±448.3)×106/L. Sugar content in CSF were approximately normal. Conclusion The clinical features of CNS-SLE are varied. MRI is more sensitive than CT in the diagnosis of CNS-SLE. Hyperpressure, increased protein concentration and increased cell count in CSF are marked abnormalities.

Key words: Lupus erythematosus, systemic, Central nervous system diseases, Laboratory techniques and procedures