Denburg S D, Denburg J A
McMaster University, Hamilton, ON, Canada.
Lupus. 2003;12(12):883-90. doi: 10.1191/0961203303lu497oa.
Nervous system involvement in systemic lupus erythematosus (SLE) is typically diagnosed on the basis of clinical psychiatric and/or neurologic syndromes (NPSLE). Neuropsychological tests can be used to assess nervous system integrity even in the absence of major NP syndromes. Their application has uncovered significant cognitive dysfunction, ranging from mild to severe, in a sizeable proportion of SLE patients irrespective of clinical NP status. Cognitive dysfunction has now been accepted as a bona fide manifestation of NPSLE. The heterogeneity of clinical NPSLE manifestations is paralleled by the diversity of cognitive deficits reported in different studies and within different patients. The success of attempts to explain these deficits on the basis of potential pathogenetic mechanisms, such as antibrain antibodies and proinflammatory cytokines, has been uneven. To date, the most robust findings have emerged in relation to antiphospholipid antibodies, which carry with them important therapeutic implications.
系统性红斑狼疮（SLE）累及神经系统通常是根据临床精神和/或神经综合征（神经精神性狼疮，NPSLE）来诊断的。即使在没有主要神经精神综合征的情况下，神经心理学测试也可用于评估神经系统的完整性。其应用已发现相当一部分SLE患者存在从轻度到重度的显著认知功能障碍，而不论其临床神经精神状态如何。认知功能障碍现已被公认为是神经精神性狼疮的一种确凿表现。临床神经精神性狼疮表现的异质性与不同研究以及不同患者中报告的认知缺陷的多样性相平行。基于潜在致病机制（如抗脑抗体和促炎细胞因子）来解释这些缺陷的尝试，其成功程度参差不齐。迄今为止，与抗磷脂抗体相关的发现最为有力，这具有重要的治疗意义。
