6例自身免疫性脑炎的临床特点及诊断方法研究

发布时间：2018-04-27 18:11

本文选题：脑炎 + 病毒性　；参考：《重庆医学》2017年14期

【摘要】：目的探讨自身免疫性脑炎不同类型的临床表现、辅助检查、确诊方法。方法回顾性分析在河北大学附属医院就诊的6例自身免疫性脑炎患者的临床表现、检查结果、治疗及预后。结果 6例患者其中2例为抗N-甲基-D-天冬氨酸(NMDA)受体抗体脑炎,2例富亮氨酸胶质瘤失活1蛋白(LGIl)抗体脑炎,2例抗γ-氨基丁酸B型(GABAB)受体抗体脑炎。患者均表现不同程度的癫痫、精神症状以及运动障碍等,临床表现形式多样,确诊依靠血液及脑脊液检查相关抗体阳性。早期进行免疫抑制疗法联合激素治疗,未合并肿瘤患者预后较好,合并肿瘤患者预后不良。结论对于以癫痫或者精神异常起病的患者,应考虑到自身免疫性脑炎的可能,及时行腰部穿刺进行脑脊液检查。
[Abstract]:Objective to investigate the clinical manifestations, auxiliary examination and diagnostic methods of autoimmune encephalitis in 6 cases of autoimmune encephalitis in the Affiliated Hospital of Hebei University. The results, treatment and prognosis of 6 cases of autoimmune encephalitis were reviewed. Of the 6 patients, 2 cases were anti N- -D- aspartic acid (NMDA) receptor antibody brain Inflammation, 2 cases of leucine glioma inactivating 1 protein (LGIl) antibody encephalitis and 2 cases of anti gamma aminobutyric acid B (GABAB) receptor antibody encephalitis. The patients showed various levels of epilepsy, mental symptoms and dyskinesia, and the clinical manifestations were varied. The diagnosis depended on the blood and cerebrospinal fluid examination related antibody positive. Early immunosuppressive therapy was carried out. The prognosis of the patients without tumor is better, and the prognosis of the patients with the tumor is poor. Conclusion for the patients with epilepsy or abnormal mental illness, the possibility of autoimmune encephalitis should be considered and the cerebrospinal fluid examination should be carried out in time by the lumbar puncture.

【作者单位】：河北大学医学院;河北大学附属医院神经内科;
【分类号】：R744.5

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