中国实用神经疾病杂志2017，Vol.20Issue(13)：37-40,4.
20例抗N-甲基-D-天冬氨酸受体脑炎患者临床特点分析
The analysis ofcharacteristics in 20 patients with anti-NMDA receptor encephalitis
温晓艳 1张迎娜 2方华 2赵雪 2张婧 2吕杰 2高峰2
作者信息
- 1. 郑州市第九人民医院重症医学科,河南 郑州 450000
- 2. 河南省(郑州大学)医药科学研究院神经免疫学研究室,河南 郑州 450052
- 折叠
摘要
Abstract
Objective Retrospectively analyzed and summarized the clinical characteristics in 20 patients with anti-NMDA receptor encephalitis,to raise the awareness of anti-NMDA receptor encephalitis.Methods The anti-NMDAR-IgG was tested in both the serum and cerebrospinal fluid (CSF)of the 90 patients who were suspected encephalitis.We analyzed the clinical manifestations,laboratory tests,treatment and prognosis of the patients who were confirmed anti-NMDA receptor encephalitis.Results 20 patients were diagnosed with anti-NMDA receptor encephalitis in the 90 patients.The ratio of the male and female was 4:16,and the median age at disease onset was 24 years.The initial symtoms and the main mental symptoms were different among the patients.The anti-NMDAR-IgG was positive both in the serum and CSF in 12 patients.The antibody was detected only in the CSF or serum in other 8 patients.Pelvic examination were found abnormal in 5 patients,and one of them was diagnosed with mature cystic ovarian teratoma in the subsequent pathological diagnosis.Electroencephalogram were abnormal in 6 patients.MRI were abnornal in 7 patients.All the patients except 1 patient who died received immunotherapy and after that the symptoms got a certain remission.The serum and the CSF of 3 patients without ovarin teratoma who had suffered the second immunotherapy were tested again,and we found that the level of the antibody decreased.Conclusion Anti-NMDAR encephalitis is common in young woman.The second-line therapy may be more effective in the patient without ovarin teratoma.The sensitivity of anti-NMDAR antibody testing is higer in CSF than in serum,therefore,examine the antibody both in serum and CSF at the same time can improve the diagnostic efficiency.关键词
抗NMDAR脑炎/畸胎瘤/免疫治疗/抗体Key words
Anti-NMDA receptor encephalitis/Ovarin teratoma/Immunotherapy/Antibody分类
医药卫生引用本文复制引用
温晓艳,张迎娜,方华,赵雪,张婧,吕杰,高峰..20例抗N-甲基-D-天冬氨酸受体脑炎患者临床特点分析[J].中国实用神经疾病杂志,2017,20(13):37-40,4.
