【摘要】 目的探讨系统性红斑狼疮脑病危险因素及影像学表现。方法选取2015年1月～2017年11月我院收治的142例系统性红斑狼疮患者,根据是否发生系统性红斑狼疮脑病,将其分为观察组(10例)与对照组(132例)。对其相关临床指标、指征以及影像学检查结果进行回顾性分析。结果观察组患者均有不同程度神经系统症状,主要表现为头痛、精神异常、意识障碍、癫痫、记忆力减退、双侧肢体无力、视觉异常和偏身麻木。查体显示,6例患者有双侧病理反射,4例患者有单侧病理反射。视乳头水肿2例,脑膜刺激征1例,眼球运动障碍1例,面瘫1例,延髓麻痹1例,共济失调1例。Logistic回归分析显示,谷丙转氨酶升高、尿红细胞升高、C3下降、抗核糖体P蛋白抗体阳性四项指标是系统性红斑狼疮脑病的危险因素(P <0.05)。观察组10例患者均接受颅脑CT和MRI检查,阳性率分别为70%和80%。结论在系统性红斑狼疮脑病相关的因素中,以谷草转氨酶、尿红细胞、C3、抗核糖体P蛋白抗体四项指标异常为其独立危险因素,本病患者影像学表现特异性不高,将CT、MRI结果与临床独立危险因素相结合,对系统性红斑狼疮脑病的诊断具有重要意义。更多还原

【Abstract】 Objective To explore risk factors and imaging manifestations of systemic lupus erythematosus encephalopathy. Methods One hundred and forty-two patients with systemic lupus erythematosus encephalopathy who were admitted and treated in our hospital from January 2015 to November 2017 were selected.According to whether systemic lupus erythematosus encephalopathy occurred,they were divided into the observation group(10 cases) and the control group(132 cases).The related clinical indexes,indications and the results of imaging examination were retrospectively analyzed. Results Patients in the observation group had different degrees of neurological symptoms,mainly manifested as headache,mental disorders,disturbance of consciousness,epilepsy,memory loss,bilateral limb weakness,visual abnormalities and partial numbness.Physical examination showed that 6 patients had bilateral pathological reflexes and 4 patients had unilateral pathological reflexes.There were 2 cases of papilledema,1 case of meningeal irritation,1 case of ocular motility disorders,1 case of facial paralysis,1 case of bulbar paralysis and 1 case of ataxia.Logistic regression analysis showed that elevated levels of alaninetransaminase,elevated Urine erythrocyte,decreased C3,and positive anti-ribosomal P protein antibody were risk factors for systemic lupus erythematosus encephalopathy(P < 0.05).10 patients in the observation group underwent CT and MRI examinations,with positive rates of 70% and 80%,respectively. Conclusion Among the factors related to systemic lupus erythematosus encephalopathy,the four independent risk factors were the abnormality of alaninetransaminase,elevated Urine erythrocyte,decreased C3 and anti-ribosomal P protein antibody.The imaging specificity of patients with this disease is not high.Combining CT and MRI results with clinical independent risk factors is of great significance for the diagnosis of systemic lupus erythematosus encephalopathy.更多还原