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[系统性红斑狼疮合并脑积水的诊断与治疗]

[The diagnosis and treatment of systemic lupus erythematosus complicated with hydrocephalus].

作者信息

Ma B T, Yin H X, Wu H, Chang J B, Zhang X, Wang L, Leng X M, Ma W B, Li Y N, Wang R Z, Wei J J

机构信息

Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2017 Jul 18;97(27):2120-2123. doi: 10.3760/cma.j.issn.0376-2491.2017.27.009.

Abstract

To investigate the pathogenesis and management of the hydrocephalus in patients with systemic lupus erythematosus (SLE). Eight cases of hospitalized lupus patients with hydrocephalus in Peking Union Medical College Hospital from Jan 1990 to Mar 2017 were analyzed retrospectively.We collected the patients' medical records including medical history, CT and/or MRI images and analysis of cerebrospinal fluid via lumbar puncture in order to investigate the pathogenesis of the hydrocephalus in patients with SLE and summarize treatment experience. All the 8 patients with SLE complicated with hydrocephalus were treated with steroids or immunosuppressive agents, and 5 cases were diagnosed with the central nervous system infection. Three cases received ventriculoperitoneal shunt, 5 cases received treatment of medicine.They all were followed up for 2-12 months, of which 3 cases were markedly effective, 1 case effective and 4 cases dead. The pathogenesis of lupus combined with hydrocephalus may have a certain relationship with the central infection, should take effective anti-infection treatment.We recommend cerebrospinal fluid shunt surgery intervention.

摘要

探讨系统性红斑狼疮(SLE)患者脑积水的发病机制及治疗方法。回顾性分析1990年1月至2017年3月在北京协和医院住院的8例狼疮性脑积水患者。收集患者病历,包括病史、CT和/或MRI图像以及通过腰椎穿刺进行的脑脊液分析,以研究SLE患者脑积水的发病机制并总结治疗经验。8例SLE合并脑积水患者均接受了类固醇或免疫抑制剂治疗,5例被诊断为中枢神经系统感染。3例行脑室腹腔分流术,5例接受药物治疗。所有患者均随访2 - 12个月,其中3例显效,1例有效,4例死亡。狼疮合并脑积水的发病机制可能与中枢感染有一定关系,应采取有效的抗感染治疗。我们建议进行脑脊液分流手术干预。

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