Kuczyńska-Zardzewiały A, Palasik W, Jedryka-Góral A, Członkowska A
II Kliniki Neurologicznej Instytutu Psychiatrii i Neurologii w Warszawie.
Neurol Neurochir Pol. 2001 Sep-Oct;35(5):781-92.
Sixty patients (51 women/9 men) with diagnosis of SLE were studied for finding out the frequency of nervous system involvement in SLE, the time of of appearance of neurological involvement after diagnosis establishing, the coexistence of the antiphospholipid syndrome, and the character of changes in MR, CT and CSF. Nervous system involvement was found in 40 cases (67%), with 34 cases (56%) had involvement of the CNS, 6 patients (10%) had symptoms of peripheral nervous system dysfunction, and 3 (5%) had involvement of both systems. In 4 cases polineuropathy and transverse spinal cord lesion, and in 3 cases psychiatric symptoms were the first manifestations of SLE. Changes due to involvement of cerebral vessels (TIA, stroke) were observed in 20 patients (33%), and psychiatric symptoms in 16 cases (26.6%). No difference was found in the occurrence of stroke or TIA between SLE patients with and without antiphospholipid syndrome, and no correlations were noted between the presence of neurological or psychiatric symptoms and other SLE symptoms. CT scans demonstrated corticosubcortical atrophy in 28.3% of cases, while in MRI in T2 images small hyperintense lesions were situated mainly in the white matter (33.9%). In 5 cases oligoclonal band was found in the CSF, but without any correlation with specific neurological symptoms.
对60例诊断为系统性红斑狼疮（SLE）的患者（51例女性/9例男性）进行了研究，以确定SLE患者神经系统受累的频率、确诊后神经受累出现的时间、抗磷脂综合征的共存情况以及磁共振成像（MR）、计算机断层扫描（CT）和脑脊液（CSF）的变化特征。40例（67%）患者存在神经系统受累，其中34例（56%）中枢神经系统受累，6例（10%）有周围神经系统功能障碍症状，3例（5%）两个系统均受累。4例患者以多发性神经病和横贯性脊髓损害为首发表现，3例患者以精神症状为SLE的首发表现。20例（33%）患者观察到脑血管受累引起的变化（短暂性脑缺血发作、中风），16例（26.6%）有精神症状。有无抗磷脂综合征的SLE患者中风或短暂性脑缺血发作的发生率无差异，神经或精神症状的出现与其他SLE症状之间无相关性。CT扫描显示28.3%的病例有皮质下萎缩，而在MRI的T2图像中，小的高信号病变主要位于白质（33.9%）。5例患者脑脊液中发现寡克隆带，但与特定神经症状无任何相关性。
