关键词: 神经精神性狼疮； 危险因素； 儿童

Abstract: Objective To explore the clinical features and risk factors of neuropsychiatric systemic lupus erythematosus (NPSLE) in children. Methods The clinical data of SLE in children hospitalized from January 2013 to December 2018 were retrospectively analyzed. Results A total of 315 children with SLE were included. 58 ( 11 boys and 47 girls) were diagnosed with NPSLE and an average age was 10 . 45 ± 2 . 63 years. There were 14 kinds of neuropsychiatric symptoms, including headache ( 21 cases), epileptic seizure ( 19 cases), cerebrovascular accident ( 15 cases), demyelinating syndrome ( 13 cases) and emotional disorder ( 10 cases). Fifty-eight children with NPSLE underwent cranial imaging examination, and 53 cases ( 91 . 4 %) were abnormal; 44 cases underwent EEG examination, and 38 cases ( 86 . 4 %) were abnormal; 39 cases underwent cerebrospinal fluid examination, and 34 cases ( 87 . 2 %) were abnormal. The incidence of platelet count < 100 × 109 /L was higher in children at first-onset of NPSLE than that in children without NPSLE, and the difference was statistically significant (P< 0 . 05 ). The case fatality rate of the 23 children ( 21 . 7 %) who developed disease from January 2013 to December 2015 was higher than that of the 35 children (case fatality rate of 2 . 9 %) who developed disease from January 2016 to December 2018 , and the difference was statistically significant (P< 0 . 05 ). Conclusions The most common symptoms of NPSLE are headache and seizures, and children with decreased platelet count have earlier neuropsychiatric symptoms. The mortality rate of children with NPSLE has decreased in recent years. Low platelet count, positive anticardiolipin antibody, and nonstandard hormone therapy are the risk factors for NPSLE in children with SLE.

Key words: neuropsychiatric systemic lupus; risk factor; child