Valentinov Monov Simeon, Valentinova Monova Daniela
Medical University Sofia, Department of Internal Diseases, Sofia, Bulgaria.
Med Pregl. 2007;60 Suppl 2:70-3.
Neuropsychiatric symptoms are recognized to occur in a significant percentage of systemic lupus erythematosus patients and to be a leading cause of morbidity and mortality in lupus. The aim of the present study is to investigate neuropsychiatric symptoms in the patients with lupus nephritis without chronic renal failure. We studied 74 patients (4 male, 70 female) with SLE without chronic renal failure. Disease activity was assessed by the European Consensus Lupus activity Measurement (ECLAM). Renal biopsies disclosed type V lesions in 23 patients, type IV--in 34, type III--in 3, type II--in 11, type I--in 3 patients. Two control groups are used--with rheumatoid arthritis (96 patients) and 63 healthy subjects. The most frequent clinical manifestations are cognitive dysfunction (52.94%), headache (29.41%), psychoses (17.65%), epileptic seizures (20.59%) etc., and the most common cognitive deficit is related to impairment of the memory. The tests for cognitive disorders and nuclear magnetic resonance are the methods of investigation, by which the nervous system injuries are most early detected in the course of the disease. The presented study describes the correlations between the immunologic deviations (antiribosomal P-antibodies, aPL, aSm, aC1q), MMP-9, AT III and the NP injuries.
神经精神症状在相当比例的系统性红斑狼疮患者中被认为会出现，并且是狼疮发病和死亡的主要原因。本研究的目的是调查无慢性肾衰竭的狼疮性肾炎患者的神经精神症状。我们研究了74例无慢性肾衰竭的系统性红斑狼疮患者（4例男性，70例女性）。疾病活动度通过欧洲狼疮活动度共识测量法（ECLAM）进行评估。肾活检显示，23例患者为V型病变，34例为IV型，3例为III型，11例为II型，3例为I型。使用了两个对照组——类风湿关节炎患者（96例）和63名健康受试者。最常见的临床表现为认知功能障碍（52.94%）、头痛（29.41%）、精神病（17.65%）、癫痫发作（20.59%）等，最常见的认知缺陷与记忆力受损有关。认知障碍测试和核磁共振是调查方法，通过这些方法可在疾病过程中最早检测到神经系统损伤。本研究描述了免疫偏差（抗核糖体P抗体、抗磷脂抗体、抗Sm抗体、抗C1q抗体）、基质金属蛋白酶-9、抗凝血酶III与神经精神损伤之间的相关性。
