摘要
目的探讨甲氨蝶呤联合氟美松鞘内注射治疗系统性红斑狼疮(SLE)中枢神经系统损害的效果。方法对28例鞘内注射的SLE中枢神经系统损害患者治疗前后的临床表现、脑脊液、头颅CT或磁共振成像(MRI)进行对比分析,并与57例未行鞘内注射者的情况进行对照。结果28例患者中2例死亡,其他患者病情均明显改善或完全缓解;脑脊液压力明显下降,蛋白水平降低,糖升高,但差异无统计学意义;6例抗核抗体(ANA)阳性者全部转阴。结论甲氨蝶呤联合氟美松鞘内注射治疗SLE中枢神经系统损害有明显效果,尤其是有定位表现者,能提高抢救成功率,副作用轻且少,值得临床推荐使用。
Objective To evaluate the intrathecal injection of combining methotrexate (MTX) and dexamethasone (DXM) into lupus patients with central nervous system involvement. Methods Twenty-eight cases of central nervous system involvement with systemic lupus erythematosus (SLE) accepted intrathecal injection of MTX plus DXM. Data including clinical manifestations, cerebrospinal fluid and skull CT or MRI before and after treatment were analyzed. Meanwhile, the mortalities between 28 cases treated with intrathecal injection and 57 cases received normal management without intrathecal injection were compared. Results Intrathecal injection of MTX plus DXM was given to 26 SLE-central nervous system (CNS) patients except 2 cases death. The symptoms and signs were remitted or relieved obviously including the decrease of pressure and protein and elevation of glucose in cerebrospinal fluid. Positive ANA in 6 cases had turned to negative after treatment. Conclusion Without any severe side effects, intrathecal injection with MTX plus DXM yielded satisfactory effects on patients with SLE-CNS, particularly in those with focus manifestations.
出处
《中华神经科杂志》
CAS
CSCD
北大核心
2005年第6期367-369,共3页
Chinese Journal of Neurology
