系统性红斑狼疮并发颅内结核感染24例回顾性研究.docVIP

系统性红斑狼疮并发颅内结核感染24例回顾性研究[摘要]目的：感染是影响系统性红斑狼患者病死率的重要因素之一，其中分枝杆菌感染主要为结核分枝杆菌。方法：回顾性分析24例SLE并发颅内结核感染（包括结核性脑炎和结核性脑膜炎）患者，分析其临床表现、脑脊液、生化学特点、影像学检查特征、治疗及转归。结果：系统性红斑狼疮并发颅内结核感染24 例（占0.36%），主要表现：发热、头痛、神经系统定位体征，脑脊液主要表现为糖和氯化物降低，血清ALB降低，头颅MRI检查对颅内结核感染有重要的诊断意义，尤其是头颅增强MRI，CSF病原学检查是结核感染的确诊依据。24例患者中，18例（75%）好转或稳定，4例失访，2例死亡（1例呼吸衰竭，1例败血症）。结论：SLE是一多系统受累性疾病，易并发各种感染，尤其结核感染诊断困难，易漏诊、误治。SLE患者在治疗过程中应严密观察，若出现临床高危因素等应注意排除颅内结核感染,一旦确诊应加强抗结核治疗。 关键词：系统性红斑狼疮；结核性脑炎；结核性脑膜炎 A retrospective study of 24 systemic lupus erythematosus patients combined with intracranial tuberculosis infection CHEN Yong ，HUANG Xiao-yan Department of Rheumatology and Immunology， Peoples Hospital of Jianyang , Sichuan 641400, China Summary Objective Infection is one of the leading causes of morbidity and mortality in Systemic lupus erythematosus (SLE) patients, and tuberculosis is the major cause of mycobacterium tuberculosis infection in SLE. Methods 24 cases of SLE combined with tuberculosis (including intracranial tuberculous encephalitis and tuberculous meningitis) patients were analyzed retrospectively. The clinical manifestations, cerebrospinal fluid, biochemistry characteristics, imaging characteristics, treatment and outcome were analysed. Result 24 SLE patients combined with intracranial tuberculosis infection were found in a total of 6670 SLE patients (0.36%). The main characteristics of SLE with intracranial tuberculosis infection are: fever, headache, nervous system positioning sighs, sugar chloride and ALB reduction in their CSF. head MRI is important in tuberculosis diagnosis, especially enhanced MRI. Pathogen examination of CSF is the basis of the diagnosis of intracranial tuberculosis infection. Conclusion SLE, a disease with multiple system involvement, combined with all kinds of infections is common. Tuberculosis infection is difficult to diagnose, and may lead to misdiagnosis and improper treatment. Therefore, it is important to monitor carefully during the treatment of SLE. When clinical signs o