Altomonte L, Mirone L, Zoli A, Magaro M
Divisione di Reumatologia, Università Cattolica S. Cuore, Roma, Italia.
Lupus. 1997;6(5):441-4. doi: 10.1177/096120339700600505.
Neurologic manifestations are known to occur in patients with systemic lupus erythematosus (SLE) and significantly affect the clinical course of the disease. Nevertheless, the prevalence, pattern and severity of autonomic impairment in such patients have yet to be defined. In the present study a series of 38 female SLE patients was assessed for the presence of autonomic dysfunction. Five noninvasive standardized cardiovascular reflex tests were used. The grading system proposed by Ewing and Clarke was applied to classifying autonomic impairment according to severity. Seventeen out of 38 patients, that is 44.7%, had evidence of autonomic impairment. Most of the patients had a mild degree of dysfunction. No correlation was found for the duration of the disease while an apparent lack of the commonly described chronological sequence of autonomic involvement was observed. We suggest that in SLE patients the prevalence of autonomic impairment, when investigated, does not significantly differ from that of other SLE-associated neurological events. The contribution of a direct immunological damage to components of neural pathways in the pathogenesis of the autonomic involvement can be postulated. Clinical consequences of autonomic impairment in patients with systemic lupus erythematosus need to be elucidated.
已知系统性红斑狼疮（SLE）患者会出现神经学表现，且这些表现会显著影响疾病的临床进程。然而，此类患者自主神经功能障碍的患病率、模式及严重程度尚未明确。在本研究中，对38例女性SLE患者进行了自主神经功能障碍检查。采用了五项非侵入性标准化心血管反射测试。应用Ewing和Clarke提出的分级系统，根据严重程度对自主神经功能障碍进行分类。38例患者中有17例（即44.7%）存在自主神经功能障碍证据。大多数患者功能障碍程度较轻。未发现疾病持续时间与之相关，且观察到自主神经受累明显缺乏通常描述的时间顺序。我们认为，在SLE患者中，经调查后自主神经功能障碍的患病率与其他SLE相关神经学事件的患病率无显著差异。可以推测，在自主神经受累的发病机制中，直接免疫损伤对神经通路成分有影响。系统性红斑狼疮患者自主神经功能障碍的临床后果有待阐明。
