Jönsen A, Bengtsson A A, Nived O, Ryberg B, Sturfelt G
Department of Rheumatology and. Department of Neurology, University Hospital of Lund, Lund, Sweden.
Rheumatology (Oxford). 2002 Nov;41(11):1308-12. doi: 10.1093/rheumatology/41.11.1308.
To investigate the outcome of neuropsychiatric involvement in systemic lupus erythematosus patients (NPSLE) recruited from a defined population.
All cases of adult SLE diagnosed during 1981-1995 within the Lund-Orup Health Care District were followed prospectively and neuropsychiatric manifestations were recorded. The SLICC/ACR (Systemic Lupus International Collaborating Clinics/American College of Rheumatology) Damage Index, mortality and working incapacity were recorded as measures of outcome.
NPSLE manifestations developed in 38% (44/117) of the patients. A high rate of organ damage (SLICC/ACR Damage Index) was recorded in the NPSLE patients (P<0.001). Compared with patients without neuropsychiatric involvement, NPSLE patients were treated more intensively, with glucocorticoids (P<0.01) and cytostatic drugs (P<0.01). When compared with the normal population in the same area, the NPSLE patients had a higher rate of working incapacity (relative risk 4.0, 95% confidence interval 2.06-6.96), whereas mortality was not increased (standardized mortality rate 1.4, 95% confidence interval 0.5-3.0).
SLE patients with neuropsychiatric involvement have an increased rate of organ damage and a high degree of working incapacity, which illustrates the severity of disease in this subgroup.
调查从特定人群中招募的系统性红斑狼疮患者（NPSLE）神经精神受累的结果。
对1981年至1995年在隆德 - 奥鲁普医疗保健区诊断出的所有成年SLE病例进行前瞻性随访，并记录神经精神表现。记录SLICC/ACR（系统性红斑狼疮国际协作诊所/美国风湿病学会）损伤指数、死亡率和工作能力丧失情况作为结果指标。
38%（44/117）的患者出现NPSLE表现。NPSLE患者的器官损伤率（SLICC/ACR损伤指数）较高（P<0.001）。与无神经精神受累的患者相比，NPSLE患者接受糖皮质激素（P<0.01）和细胞毒性药物（P<0.01）治疗的强度更大。与同一地区的正常人群相比，NPSLE患者的工作能力丧失率较高（相对风险4.0，95%置信区间2.06 - 6.96），而死亡率未增加（标准化死亡率1.4，95%置信区间0.5 - 3.0）。
有神经精神受累的SLE患者器官损伤率增加且工作能力丧失程度高，这表明该亚组疾病的严重性。
