Clinical Features And Imaging Investigation Of Neuropsychiatric Systemic Lupus Erythematosus

Objective:The clinical and laboratory characteristics and head imaging data of patients with neuropsychiatric systemic lupus erythematosus(NPSLE)were retrospectively analyzed to investigate the laboratory indicators related to the incidence of NPSLE.The relationship between NPSLE and imaging manifestations was analyzed,so as to improve the understanding and diagnosis of NPSLE,and provide guidance for clinical treatment and disease prognosis.Methods:A total of 63 SLE patients hospitalized in the rheumatology department of our hospital from January 2015 to September 2021 were selected from the electronic case system,and they were divided into the SLE group complicated with lupus encephalopathy and the mesenteric vascullitis group,there were no patients with NPSLE and mesenteric vasculitis at the same time in 63 patients.The clinical data of the two groups were compared and statistically analyzed by SPSS 26.0 software.Results:1.Pulmonary infection and lupus nephritis(LN)are common complications of NPSLE.2.The positive rates of anti-SSA antibody,anti-SM antibody and anti-U1-RNP antibody in NPSLE patients were higher than those in lupus mesenteric vasculitis(LMV)patients.There was a difference in the positive rate of anti-U1-RNP antibody between the two groups(P < 0.05),and no significant difference was found in other laboratory results.3.Abnormal head magnetic resonance imaging(MRI)of NPSLE patients accounted for 75.0%,and the lesion nature was mostly white matter lesions(37.5%),cerebral infarction(21.9%),cerebral atrophy(18.8%)were the next most common.4.Anti-ribosomal P protein antibody was associated with brain atrophy in patients with NPSLE(P=0.015,Pearson’s column association number r=0.416).NPSLE patients serum ANA,anti-ds-DNA antibody,anti-SM antibody,anti-SSA antibody,anti-SSB antibody,anti-ribosomal P protein was not associated with included head MRI lesions(macrovascular lesions,ventricular dilatation,brain atrophy,cerebral infarction,and white matter lesions).Conclusion:Patients with NPSLE are more likely to have positive anti-U1-RNP antibody than patients with LMV.Brain atrophy on head MRI was more likely to occur in patients with anti-ribosomal P protein antibody positive NPSLE.Some of the preliminary associations found in this study deserve further exploration,and more in-depth studies of NPSLE can be conducted in the future using neuroimaging and biomarkers.