Abstract: Objective To investigate the risk factors,clinical manifestations and treatment of neuropsy-chiatric systemic lupus erythematosus(NPSLE).Methods Clinical data,including clinical manifestations, laboratory examination results and SLE disease activity index(SLEDAI)score,were retrospectively analyzed for 42 patients with NPSLE and 187 patients with non-NPSLE as controls.Neuropsychiatric manifestations were classified according to the American College of Rheumatology(ACR)nomenclature and case definition for NPSLE.Results Of all NPSLE patients,50% had definite precipitating cause before neuropsychiatric symptoms occurred.A total of 12 types of neuropsychiatric manifestation were observed,and 73.8% patients presented two or more clinical types.The most common symptoms involved epilepsy(27.0%),cere-brovascular disease(20.6%)and acute confusional states(14.3%).The incidence of fever,elevated ESR and thrombocytopenia,as well as the mean SLEDAI score and mortality rate were higher in NPSLE group than in non-NPSLE group(all P<0.05).However,the incidence of discoid erythema and arthralgia,as well as the percentage of the patients receiving regular treatment with steriods or combination therapy with immunosuppressants were significantly lower in NPSLE group than in non-NPSLE group(all P<0.05). The causes of death included NPSLE itself and complicated infection and organ failures.Conclusions The patients with NPSLE usually have a more severe condition,higher disease activity and worse prognosis than those with non-NPSLE.Regular treatment and prevention of complications with systemic steriods and immuno-suppressants might prevent the occurrence of NPSLE and improve the prognosis of SLE.

Key words: Lupus vasculitis, Central nervous system, Nervous system, Psychotic disorders