Clinical analysis of 30 cases of nervous systemic lupus erythematosus / 中国基层医药

ABSTRACT

Objective To invetigate clinical characteristics,pathogenesis and its risk factors of neuropsychi-atric lupus erythematosus(NPLE).Methods 160 cases of SLE patients,including 30 cases of diagnosed NPLE,were analyzed retrospectively.The relationship between the appearance of NPLE and common autoantibodies,other organ involvement and SLE disease activity score(SLEDAI)were analyzed.Results Such antibody positive rates of anti nuclear antibody(ANA),anti Sm antibody,anti -RNP antibody,anti SSA antibody,anti ds -DNA antibody had no significant difference between NPLE and non NPLE,the value of χ2 was 0.947,0.013,1.194,0.023,0.745 respectively,the value of P was 0.194,0.910,0.274,0.879,0.388 respectively.Renal involvement,raynaud phenomenon,interstitial pneumonia,pulmonary thromboembolism,oral ulcer,arthritis,facial erythema,pleuritis,pericarditis,fever,pulmonary hypertension,photo -allergy and alopecia in the two groups had no difference,the value of χ2 was respectively 0.419,1.383,0.721,0.201,1.368,1.194,0.055,0.946,0.262,2.503,0.628,2.898 and 0.075,the value of P was 0.517,0.324,0.396,1.000,0.242,0.274,0.815,0.331,0.609,0.114,0.428,0.089 and 0.785 respectively.But the occurrence of hand and foot vasculitis in NPLE was significantly higher(χ2 =3.996,P =0.046).SLEDAI of NPLE was higher than non NPLE(t =8.446,P =0.000).Conclusion There was no correlation with the occurrence of NPLE and common autoantibodies,other organ involvements.Hand and foot vasculitis and higher SLEDAI(more than 15 points)were the risk factors of NPLE.Encephalopathy may be the initial manifestation to some of SLE cases. Early diagnosis and methylprednisolone pulse treatment combined with immunosuppressive therapy can effectively improve the remission of the disease,reduce mortality and improve prognosis.