摘要
目的探讨狼疮性脑病患儿的临床免疫表现及高危因素,为临床早期鉴别诊断、防治寻找依据。方法回顾性选取2015年1月1日至2022年4月30日湖南省儿童医院收治的系统性红斑狼疮(SLE)患儿94例,其中出现狼疮性脑病表现的19例患儿为神经精神性系统性红斑狼疮(NPSLE)组,未出现狼疮性脑病表现的75例患儿为SLE组。比较两组患儿的疾病活动、免疫全套、淋巴细胞亚群、炎症因子及自身抗体水平。结果94例SLE患儿中,NPSLE的发生率为20.21%(19/94)。19例NPSLE患儿最常见的症状为头痛、癫痫发作和脑血管病,SLEDAI-2000评分(19.89±8.33)分,大部分患儿通过激素干预后预后较好。与SLE组相比,NPSLE组SLEDAI-2000评分、白细胞计数、尿蛋白定量、ESR、IFN-α更高,血小板计数、IL-2、C_(3)、C_(4)更低,抗Sm抗体、抗心磷脂抗体阳性率更高,差异均有统计学意义(均P<0.05),而抗dsDNA抗体、抗SSA抗体阳性率比较差异无统计学意义(均P>0.05)。结论与SLE患儿比较,狼疮性脑病患儿往往合并多种免疫功能异常,以体液免疫功能为主,多种抗体阳性,炎症因子水平升高。
Objective To explore the clinical immune manifestations and high risk factors of children with neuropsychiatric systemic lupus erythematosus(NPSLE),so as to find the basis for early clinical differential diagnosis,prevention and treatment of NPSLE.Methods Ninety-four children with systemic lupus erythematosus(SLE)admitted to Hunan Children′s Hospital from January 1,2015 to April 30,2022 were retrospectively selected.Among them,19 children with NPSLE were in the NPSLE group,and 75 children without NPSLE were in the SLE group.The disease activity,immune system,lymphocyte subsets,inflammatory factors and autoantibodies were compared between the two groups.Results Among 94 children with SLE,the incidence of NPSLE was 20.21%(19/94).The most common symptoms of 19 children with NPSLE were headache,epileptic seizure and cerebrovascular disease.The Systemic Lupus Erythematosus Disease Activity Index(SLEDAI)-2000 score was(19.89±8.33)points.Most of them had a good prognosis through hormone intervention.Compared with the SLE group,NPSLE group had higher SLEDAI-2000 score,white blood cell count,urine protein,erythrocyte sedimentation rate(ESR),interferon(IFN)-α,positive rate of anti-Sm antibody and anticardiolipin antibody,lower platelet count,interleukin-2(IL-2),C_(3),C_(4)level(all P<0.05),while there was no significant difference in positive rate of anti-dsDNA antibody and anti-SSA antibody between the two group(both P>0.05).Conclusions Compared with SLE children,children with NPSLE are often complicated with many kinds of abnormal immune function,mainly abnormal humoral immune function and many kinds of positive antibody,with increased inflammatory factors.
作者
吴天慧
李志辉
寻劢
吴敏
尹飞
Wu Tianhui;Li Zhihui;Xun Mai;Wu Min;Yin Fei(Department of Renal,Rheumatism and Immunity,Hunan Children′s Hospital,Changsha 410007,China;Department of Pediatrics,the People′s Hospital of Shimen,Shimen 415300,China;Department of Pediatric Neurology,Xiangya Hospital,Central South University,Changsha 410008,China)
出处
《中国医师杂志》
CAS
2022年第10期1449-1453,共5页
Journal of Chinese Physician
关键词
狼疮血管炎
中枢神经系统
红斑狼疮
系统性
儿童
Lupus vasculitis,central nervous system
Lupus erythematosus,systemic
Child
