自身免疫性脑炎17例临床特点分析

目的:探讨自身免疫性脑炎(AE)的临床特点及预后。方法:回顾性分析我院确诊为AE的患者17例的临床资料,分析其临床特点、实验室检查、治疗及转归。结果:本组12例为抗N-甲基-D-天冬氨酸受体(NMDAR)脑炎,1例为抗富含亮氨酸胶质瘤失活蛋白1(LGI1)脑炎,4例为抗γ-氨基丁酸b受体(GABAbR)脑炎。出现精神症状13例(76.47%),出现意识水平下降8例(47.06%),出现癫痫发作15例(88.24%),伴有卵巢畸胎瘤仅1例。所有病例均根据病情严重程度选择使用不同剂量的激素治疗,其中联合免疫球蛋白(IVIG)治疗12例,合并使用免疫抑制剂5例。治疗后症状明显缓解15例。结论:AE以精神障碍、癫痫、认知功能下降为主要临床特点,早期诊断及治疗有利于改善预后。

Analysis of Clinical Characteristics of Autoimmune Encephalitis: 17 Cases Report

Objective:To analyze the clinical characteristics and prognosis of patients with autoimmune encephalitis (AE).Methods:We collected the data of 17 cases with AE.The data of clinical characteristics,laboratory examinations,treatment and prognosis of 17 cases were analyzed.Results:Among these patients,12 of them were proved to have anti-N-methyl-D-aspartate receptor (NMDAR) antibody,1 had anti-leucine-rich glioma-inactivated protein 1 (LGI1) antibody,and the other 4 had anti-γ-aminobutyric acid b receptor (GABAbR) antibody.Clinically,thirteen cases (76.47％) had psychological symptoms,8 cases (47.06％) had reduced consciousness,15 cases (88.24％) had a seizure,and only 1 case had ovarian teratoma.All cases were treated with glucocorticoid,while 12 patients were combined with IVIG and 5 patients were accepted immunosuppressive therapy.The symptoms were relieved in 15 cases.Conclusion:AE is mainly manifested as mentally-ill,epileptic seizures,and reduced consciousness.Early diagnosis and treatment can improve the prognosis.