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Autoantibodies Involved in Neuropsychiatric Systemic Lupus Erythematosus and Its Diagnostic Value
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摘要: 神经精神性狼疮(neuropsychiatric systemic lupus erythematosus, NPSLE)是系统性红斑狼疮(systemic lupus erythematosus, SLE)病变累及神经系统而产生神经和/或精神症状的一组预后差、死亡率高的严重并发症, SLE患者血清或脑脊液中检测到的独特的自身抗体与神经精神疾病相关。在SLE患者中, NPSLE的患病率从17%至75%不等。本文论述国内外最新研究结果, 着重探讨抗核糖体P抗体、抗磷脂抗体、抗神经元抗体等相关抗体在中枢神经受累的NPSLE中的研究现状及其临床价值。Abstract: Neuropsychiatric systemic lupus erythematosus (NPSLE) is a group of severe complications with a poor prognosis and high mortality caused by systemic lupus erythematosus (SLE). Its lesions involve the nervous system and cause neurological and/or psychiatric symptoms. Unique autoantibodies detected in the serum or cerebrospinal fluid of patients with NPSLE are associated with the presence of neuropsychiatric disorders. The prevalence of NPSLE ranges from 17% to 75% in SLE. This article reviewed the latest progress and focused on the current state of knowledge and the potential clinical value of anti-ribosomal P antibody, antiphospholipid antibody, anti-neuronal antibody, and other related antibodies in NPSLE with central nervous involvement.利益冲突 无
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表 1 NPSLE自身抗体靶点及其相关临床表现
抗体 定位 靶点 神经系统表现 参考文献 抗非特异性细胞成分抗体 抗核糖体P抗体 血清/脑脊液 全身 精神病、抑郁症 [14, 16] 抗Sm抗体 血清/脑脊液 全身 癫痫、精神病 [17] 抗SmD1抗体 血清/脑脊液 全身 癫痫 [20] 抗磷脂抗体 血清/脑脊液 全身 癫痫、舞蹈病、痴呆、精神病、抑郁症、认知功能障碍、偏头痛 [21] 抗神经元成分抗体 抗神经元抗体 血清 神经系统 认知功能障碍 [26-27] 抗NR2抗体 血清/脑脊液 神经系统 认知功能障碍、抑郁症 [28, 33-34] 抗神经节甙抗体 血清/脑脊液 神经系统 偏头痛、认知功能障碍、抑郁症、周围神经病变 [35] 抗γ-氨基丁酸受体抗体 血清/脑脊液 神经系统 急性混乱状态 [9] 抗胶质纤维酸性蛋白抗体 血清 神经系统 器质性脑病表现 [39] 抗微管相关蛋白-2抗体 血清 神经系统 精神病、癫痫、神经病、脑炎 [40] 抗内皮细胞抗体 血清/脑脊液 全身 精神病、抑郁症 [42] NPSLE:神经精神性狼疮 
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