Hanly J G, Walsh N M, Sangalang V
Department of Medicine, Victoria General Hospital, Halifax, NS, Canada.
J Rheumatol. 1992 May;19(5):732-41.
Brain pathology was documented in 10 patients with systemic lupus erythematosus (SLE), 7 of whom had clinical neuropsychiatric SLE prior to death. This was manifested by seizures (5 patients), organic brain syndrome (3 patients) and psychosis (2 patients). Multifocal cerebral cortical microinfarcts, associated with microvascular injury, were documented in 4 patients and in our study constituted the predominant histopathologic abnormality attributable to SLE. Changes of a healed vasculitis in medium sized leptomeningeal vessels were seen in 1 case. Agreement between the clinical and pathologic classification of neuropsychiatric SLE was observed in 7/10 (70%) cases and the strongest association was between the presence of cerebral microinfarcts and seizures (4/5 patients, p less than 0.05). No correlation was observed with anticardiolipin, anti-P, lymphocytotoxic and antineuronal antibodies.
10例系统性红斑狼疮（SLE）患者有脑部病变记录，其中7例在死亡前患有临床神经精神性SLE。表现为癫痫发作（5例）、器质性脑综合征（3例）和精神病（2例）。4例患者记录有多灶性脑皮质微梗死，与微血管损伤相关，在我们的研究中构成了SLE所致的主要组织病理学异常。1例患者在软脑膜中等大小血管中可见愈合性血管炎的改变。在7/10（70%）的病例中观察到神经精神性SLE临床和病理分类之间的一致性，最强的关联是脑微梗死的存在与癫痫发作之间（4/5例患者，p<0.05）。未观察到与抗心磷脂、抗P、淋巴细胞毒性和抗神经元抗体之间的相关性。
