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[系统性红斑狼疮中枢神经系统受累的临床免疫学特征:与抗心磷脂抗体的关系]

[The clinico-immunological characteristics of central nervous system involvement in systemic lupus erythematosus: the relationship with antibodies to cardiolipin].

作者信息

Travkina I V, Ivanova M M, Nasonov E L, Shmidt T E, Kovalev V Iu

出版信息

Ter Arkh. 1992;64(5):10-4.

PMID:1455360
Abstract

As many as 30 patients suffering from systemic lupus erythematosus (SLE) with the clinical signs of central nervous system derangement were examined. The mean age of the patients was 31.1 years. Using EIA, antibodies against cardiolipin (a-CL) were detected in 21 patients (70%). A-CL were revealed in all the patients with cerebral circulation impairment (CCI), choreic hyperkinesis, and convulsive syndrome. A-CL were discovered in 12 out of 18 SLE patients suffering from migraine-like headaches and in 4 out of 5 patients with mental disorders. Antibodies reacting with cardiolipin were mostly represented by the IgM isotype (80%) whereas a-CL-IgG were only identified in 13% of the patients, being associated in all the cases with a-CL-IgM. The high level of a-CL-IgG in blood serum was recorded in patients with the gravest patterns of nervous system derangement: CCI, occlusion of the retinal artery, psycho-organic and convulsive syndromes. All these patients demonstrated generalized reticular livedo. The high levels of a-CL-IgM were observed in SLE patients with choreic hyperkinesis and migraine-like headaches. Thus, the studies made it possible to trace the relationship between the development of certain neurological disorders (CCI, chorea, convulsive syndrome) in SLE patients and a-CL.

摘要

对多达30例患有系统性红斑狼疮(SLE)且有中枢神经系统紊乱临床体征的患者进行了检查。患者的平均年龄为31.1岁。采用酶免疫分析(EIA)法,在21例患者(70%)中检测到抗心磷脂抗体(a-CL)。在所有患有脑循环障碍(CCI)、舞蹈性运动亢进和惊厥综合征的患者中均发现了a-CL。在18例患有偏头痛样头痛的SLE患者中有12例发现了a-CL,在5例精神障碍患者中有4例发现了a-CL。与心磷脂反应的抗体大多为IgM同种型(80%),而a-CL-IgG仅在13%的患者中检测到,且在所有病例中均与a-CL-IgM相关。血清中a-CL-IgG水平高的患者具有最严重的神经系统紊乱类型:CCI、视网膜动脉闭塞、精神器质性和惊厥综合征。所有这些患者均表现为全身性网状青斑。在患有舞蹈性运动亢进和偏头痛样头痛的SLE患者中观察到a-CL-IgM水平较高。因此,这些研究使得追踪SLE患者某些神经系统疾病(CCI、舞蹈病、惊厥综合征)的发生与a-CL之间的关系成为可能。

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