Clinical Analysis of Fifty five Patients with Neuropsychiatric Lupus

LIN Fuan; ZHAO Ting; HUANG Xiaolu; CHEN Hongpu

doi:10.13919/j.issn.2095-6274.J202403056

Abstract：Objective To explore the clinical characteristics of Neuropsychiatric Systemic Lupus Erythematosus(NPSLE)and the efficacy of combined intrathecal injection Dexamethasone therapy.Methods The neurological manifestations,laboratory examination,cerebrospinal fluid examination and cranial magnetic resonance examination of 55 patients with neuropsychiatric lupus admitted to Zhangzhou Hospital in Fujian Province from January 2019 to December 2019 were retrospectively analyzed,and the patients were divided into the conventional treatment group and the conventional treatment combined with intrathecal injection group(the combined group)according to treatment methods.The therapeutic effects of different treatment groups were recorded and analyzed.Results Epilepsy is the most common clinical manifestation of neuropsychiatric lupus,followed by cerebral infarction,headache,and mental disorders;with 80％showing severe activity,60％showing abnormalities in routine cerebrospinal fluid examination,and 29.1％showing abnormal signals on brain MRI.The therapeutic effect of the combined intrathecal hormone injection group was significantly better than that of the conventional treatment group,with effective rates of 93.55％and 66.67％,respectively.At 1 year follow-up,the relapse rate and QOL score of the combined group were lower than those of the control group(P＜0.05),and the difference of survival rate was not significant(P＞0.05).Conclusion Neuropsychiatric lupus is a serious disease.The diagnosis should be made in combination with clinical symptoms,cerebrospinal fluid examination,brain MRI,and etc.Hormone and Immunosuppressive drug are basic treatment,and combined intrathecal hormone injection is helpful to improve the efficacy.