Ivanova M M, Blizniuk O I, Shchekut'ev G A, Pushkova O V
Revmatologiia (Mosk). 1991 Oct-Dec(4):6-9.
A total of 60 patients with systemic lupus erythematosus (SLE) were under observation; 36 of them had clinical symptoms of the CNS affection and 25 persons included into the control group exhibited no psychic disorders during the clinical examination. Besides, routine clinico-laboratory examinations accepted in rheumatology, the patients were subjected to cranial computer tomography (CT), electroencephalography, examination of cerebral hemodynamics with a radionuclide partechnetate 99mC as well as to psychological testing. Neuropsychic disorders developed during the first four years after the onset of the disease and are grouped in the following way: neurological, border-line, neuropsychic, affective, psychotic, intellectual-mnestic. Moderate affection of the CNS in SLE is characterized by a complex of subjective and objective symptoms: headache, deterioration of memory, insomnia, vertigo, irritability, depressed mood, assymetry of the face innervation, coordinatory disorders. Diffuse widening of the subarchnoidal space, diffuse cerebral changes, interhemispheric assymetry of the venous and arterial phases of cerebral circulation: the most peculiar symptoms of the CNS affection in SLE according to CT and EEG and radionuclide studies of cerebral hemodynamics. Focal changes in the CNS were observed in 50% of the patients with neuropsychic disorders.
共观察了60例系统性红斑狼疮(SLE)患者;其中36例有中枢神经系统受累的临床症状,25例纳入对照组的患者在临床检查中未出现精神障碍。此外,除了风湿病常规的临床实验室检查外,患者还接受了头颅计算机断层扫描(CT)、脑电图检查、用放射性核素锝99mC检查脑血流动力学以及心理测试。神经精神障碍在疾病发作后的头四年内出现,并按以下方式分类:神经、边缘性、神经精神、情感、精神、智力记忆。SLE患者中枢神经系统中度受累的特征是一系列主观和客观症状:头痛、记忆力减退、失眠、眩晕、易怒、情绪低落、面部神经支配不对称、协调障碍。蛛网膜下腔弥漫性增宽、弥漫性脑改变、脑循环静脉和动脉期的半球间不对称:根据CT、脑电图和脑血流动力学放射性核素研究,这些是SLE患者中枢神经系统受累最特殊的症状。50%有神经精神障碍的患者观察到中枢神经系统的局灶性改变。