抗N-甲基-M-天冬氨酸受体抗体阳性脑炎临床特征分析

目的 分析抗N-甲基-M-天冬氨酸(NMDA)受体抗体阳性脑炎患者的临床症状、体征、影像学及脑脊液检查特点.方法 收集2015年7月至2017年10月在安徽医科大学第一附属医院就诊的11例脑脊液中抗NMDA受体抗体阳性脑炎患者的资料,分析总结其临床表现、诊疗过程以及疾病转归.结果 11例患者临床主要表现为精神异常、癫痫发作、运动障碍,MRI检查有3例异常,病灶主要位于颞叶、额叶、基底节区等处,脑电图检查主要以慢波改变为主,无特异性,其中3例患者合并畸胎瘤,1例预后不佳,其余患者不同程度好转,预后良好.结论 临床应提高对抗NMDA受体阳性脑炎的认识,对疑似病例要早期完善抗NMDA受体抗体检查,临床诊断要综合患者症状以及各项检查分析,防止误诊、漏诊.

Analysis of clinical data of 11 cases of anti NMDA receptor encephalitis

Objective To summarize the characteristics of clinical manifestations and assistant examination of anti -N-methyl-D-as-partate receptor encephalitis patients,and to improve the understanding and diagnosis of the disease.Methods We retrospectively analyzed the clinical symptoms,auxiliaryexamination,treatment and prognosis of 11 patients with positive anti NMDA receptor antibody in the cerebro-spinal fluid in the First Affiliated Hospital of Anhui Medical University.Results The main manifestations of 11 cases were mental disorders, epilepsy,motor disorders.MRI and EEG showed no specific changes.Three female patients suffered from teratoma and received operation. One patient had a poor prognosis.Conclusion Clinicians should improve the understanding of NMDA receptor encephalitis,and early anti MDA receptor antibody screening is necessary.Diagnosis of anti-NMDA receptor encephalitis requires a comprehensive analysis including pa-tient's clinical symptoms and clinical examination to avoid misdiagnosis.