抗N-甲基-D-天门冬氨酸受体脑炎与病毒性脑炎的关系

抗N-甲基-D-天门冬氨酸受体(anti-N-methyl-d-aspartate receptor,NMDAR)脑炎是一种常见的自身免疫性脑炎,近年来逐渐被神经医学领域所认识.该病具有相对一致的临床表现,脑脊液具有特异性的抗NMDAR抗体,免疫治疗有较好的临床效果.抗NMDAR脑炎与病毒性脑炎关系密切,在认识该病之前,其常常被误诊为病毒性脑炎.近来大量研究发现病毒感染是抗NMDAR脑炎的重要诱发因素,而部分病毒性脑炎尤其是单纯疱疹病毒脑炎的复发,是由病毒感染继发中枢神经系统免疫性炎性反应所致,需要进行免疫治疗.因此认识抗NMDAR脑炎及其与病毒性脑炎的关系,对患者的诊治与预后有重要影响.

The relationship between anti-N-methyl-D-aspartate receptor encephalitis and viral encephalitis

Anti-N-methyl-D-aspartate receptor(NMDAR) encephalitis is a common autoimmune encephalitis.It is recognized gradually in neurological field in recent years.This disease has relatively consistent clinical manifestations.There is a specific anti-NMDAR antibody in cerebrospinal fluid,and a good response to immune therapy.Anti-NMDAR encephalitis is closely associated with viral encephalitis.It is often misdiagnosed as viral encephalitis before it is well understood.Recently,a number of studies have found that virus infection is an important inducing factor of anti-NMDAR encephalitis.The recurrence of the viral encephalitis,especially herpes simplex virus encephalitis,is partially caused by immunological reaction of the central nervous system secondary to virus infection,and the immunological therapy is necessary.The recognition of anti-NMDAR encephalitis and its relationship with viral encephalitis,is very important for the proper treatment and improving the outcome of the patients.