目的：应用MRI常规序列对系统性红斑狼疮（SLE）患者脑内血管周围间隙扩大（EPVS）、白质高信号（WMH）及腔隙灶进行评估，初步分析SLE患者脑小血管病变的MRI表现。材料与方法：回顾性收集29例SLE患者及29例年龄、性别与SLE组相匹配的健康体检者作为对照组。通过观察EPVS、WMH及腔隙灶的情况，对其进行相应的分级及评分。并记录SLE患者临床及化验室检查指标。应用SPSS 24.0版统计软件进行数据分析，等级资料用Kolmogorov-Smirnov Z检验分析组间差异，应用Spearman相关分析法分析EPVS、WMH及腔隙灶与临床、实验室检查之间的相关性。结果：在半卵圆中心，SLE组的EPVS评分（2.52±0.91）显著高于对照组（1.34±0.55，P<0.01）；SLE组脑室周围白质高信号（PVH）和深部脑白质高信号（DWMH）均较对照组更明显（P<0.01）；SLE组腔隙灶的发生率高于对照组（P＜0.05）。并且半卵圆中心EPVS及PVH与补体C3相关（r=0.505，0.400，P均＜0.05）；EPVS和WMH与病程呈正相关（r=0.460、0.428、0.416、0.404，P均＜0.05）。结论：脑小血管病变是SLE中枢神经系统病变的常见表现，并与补体C3及病程具有关联性。
Abstract
Objective: To evaluate MRI findings of enlarged perivascular space(EPVS), white matter hyperintense (WMH) and lacunes of cerebral small vessel disease(CSVD) in patients with systemic lupus erythematosus(SLE). Materials and Methods: Twenty-nine SLE patients and twenty-nine age- and sex-matched healthy subjects participated in this retrospective study. EPVS, WMH, and lacunes were rated by two radiologists. SPSS 24.0 was used for data statistical analysis, Kolmogorov-Smirnov Z test was used to analyze group difference, and Spearman correlation analysis was used to analyze the correlation between CSVD and clinical and laboratory examination. Results: In the centrum semiovale(CS), the EPVS score in the SLE group was higher than that in the control group(2.52±0.91, 1.34±0.55, P<0.01). The periventricular hyperintense(PVH) and deep white matter hyperintense(DWMH) in the SLE group were more significant than those in the control group(P<0.01), and the incidence of lacunes in SLE group was higher than that in the control group(P<0.05). In SLE group, EPVS in the CS and PVH were correlated with complement C3(r=0.505, 0.400, P<0.05), EPVS score and WMH were positively correlated with disease duration(r=0.460, 0.428, 0.416, 0.404, P<0.05). Conclusion: Cerebral small vessel disease is a common manifestation of central nervous system lesions in SLE patients and is associated with complement C3 and disease duration.
关键词
红斑狼疮 /
系统性 /
脑血管障碍 /
磁共振成像
Key words
Lupus erythematosus, systemic /
Cerebrovascular disorders /
Magnetic resonance imaging
中图分类号：
R593.24
Ｒ743
Ｒ445.2
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基金
国家自然科学基金项目（编号：81671646，81801657）。
