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系统性自身免疫性疾病合并脑积水:发病机制与管理

Systemic autoimmune diseases complicated with hydrocephalus: pathogenesis and management.

作者信息

Wei Junji, Yin Hexiang, Wang Li, Cui Liying, Wang Renzhi

机构信息

Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, No. 1 Shuaifuyuan Hutong, Dongcheng District, Beijing, 100730, People's Republic of China.

Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, People's Republic of China.

出版信息

Neurosurg Rev. 2019 Jun;42(2):255-261. doi: 10.1007/s10143-017-0917-x. Epub 2017 Nov 12.

Abstract

Systemic autoimmune diseases (SAIDs) represent a group of syndromes involving at least two organ systems. Classical SAIDs include connective tissue diseases, vasculitis, and granulomatous diseases, many of which involve the nervous system and result in different neurological manifestations. Hydrocephalus can be a rare but lethal complication of various SAIDs, including systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), sarcoidosis, and primary vasculitis. However, the pathogenesis of SAIDs complicated with different types of hydrocephalus is varied and difficult to determine using the existing published data, and various manifestations and expressive forms of the conditions bring a substantial challenge to a timely clinical diagnosis and treatment. The commonly used medical management programs based on the etiology of hydrocephalus are anti-inflammatory or anti-infectious therapies, while surgical management such as ventriculoperitoneal shunts is effective most of the time. Further research should be directed toward improving our understanding of the pathogenesis of these conditions and determining the most effective method for treating this life-threatening condition.

摘要

系统性自身免疫性疾病(SAIDs)是一组涉及至少两个器官系统的综合征。典型的SAIDs包括结缔组织病、血管炎和肉芽肿性疾病,其中许多疾病累及神经系统并导致不同的神经表现。脑积水可能是各种SAIDs(包括系统性红斑狼疮(SLE)、类风湿关节炎(RA)、结节病和原发性血管炎)的一种罕见但致命的并发症。然而,SAIDs并发不同类型脑积水的发病机制各不相同,利用现有的已发表数据难以确定,而且这些病症的各种表现和表达形式给及时的临床诊断和治疗带来了巨大挑战。基于脑积水病因的常用药物治疗方案是抗炎或抗感染疗法,而诸如脑室腹腔分流术等手术治疗在大多数情况下是有效的。未来的研究应致力于增进我们对这些病症发病机制的理解,并确定治疗这种危及生命病症的最有效方法。

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