自身免疫性脑炎预后相关因素的分析

发布时间：2018-06-19 20:22

本文选题：自身免疫性脑炎 + 预后　；参考：《吉林大学》2017年硕士论文

【摘要】：自身免疫性脑炎临床表现多样,伴或不伴肿瘤,脑脊液、影像学及血清学检查无明显特异性,极易误诊。该病主要根据脑脊液和(或)血清中检测到相关抗体而确诊,而相关抗体检测结果需较长时间,因此延误诊断,不利于治疗。据此自身免疫性脑炎的国际临床诊断标准和排除标准已被提出。国外学者提出早期免疫治疗及避免进入重症监护室是抗NMDAR脑炎预后良好的因素,通过相关文献复习,目前国内尚无学者对影响自身免疫性脑炎预后的相关因素进行大数据统计回顾分析,本课题就自身免疫性脑炎预后的相关因素进行分析及评估,以提高对AE及其预后的认识,并为其及时诊治及改善预后提供依据。目的:研究自身免疫性脑炎预后的相关因素,并对其进行分析及评估,以提高AE及其预后的认识,为其及时诊治及改善预后提供参考依据。方法:回顾性分析52例AE患者的临床资料,比较预后良好组与预后不良组患者之间的各项临床资料特征,利用SPSS23.0软件进行统计数据分析,探讨影响自身免疫性脑炎预后的相关因素。结果:单因素分析得出:伴基础疾病、发热、神经局灶症状及体征、意识障碍、通气障碍、心率及血压异常等自主神经症状、免疫治疗、抗AMPA受体抗体在预后良好组和预后不良组之间有统计学差异;经多变量Logistic回归分析,筛选出意识障碍、免疫治疗是影响自身免疫性脑炎预后的独立危险因素。结论:(1)意识障碍和免疫治疗是影响自身免疫性脑炎预后的独立因素。(2)存在意识障碍的患者预后不良,早期给予免疫治疗可改善预后。
[Abstract]:The clinical manifestations of autoimmune encephalitis are various, with or without tumor, cerebrospinal fluid, imaging and serological examination without obvious specificity, so it is easy to be misdiagnosed. The diagnosis of the disease is mainly based on the detection of related antibodies in cerebrospinal fluid and / or serum, but the results of detection of related antibodies take a long time, so the diagnosis is delayed and is not conducive to treatment. Accordingly, the international diagnostic criteria and exclusion criteria for autoimmune encephalitis have been proposed. Foreign scholars put forward that early immunotherapy and avoiding entry into intensive care unit are good prognostic factors of NMDAR encephalitis. At present, there are no scholars in China to make a retrospective big data statistical analysis of the related factors affecting the prognosis of autoimmune encephalitis. In order to improve the understanding of AE and its prognosis, this paper analyzes and evaluates the factors related to the prognosis of autoimmune encephalitis. And to provide basis for timely diagnosis and treatment and improve prognosis. Objective: to study the prognostic factors of autoimmune encephalitis, and to analyze and evaluate them so as to improve the understanding of AE and its prognosis, and to provide reference for timely diagnosis and treatment of autoimmune encephalitis. Methods: the clinical data of 52 patients with AE were analyzed retrospectively. The clinical data were compared between the patients with good prognosis and those with poor prognosis. The statistical data were analyzed by SPSS 23.0 software. Objective: to investigate the prognostic factors of autoimmune encephalitis. Results: univariate analysis showed that autonomic nervous symptoms, such as basic diseases, fever, neurological focal symptoms and signs, disturbance of consciousness, disturbance of ventilation, abnormal heart rate and blood pressure, were associated with immunotherapy. The anti-AMPA receptor antibody had statistical difference between the group with good prognosis and the group with poor prognosis, and was screened out by multivariate logistic regression analysis, and immunotherapy was an independent risk factor affecting the prognosis of autoimmune encephalitis. Conclusion (1) consciousness disorder and immunotherapy are independent factors influencing the prognosis of autoimmune encephalitis. The prognosis of patients with consciousness disorder is poor. Early immunotherapy can improve the prognosis of patients with autoimmune encephalitis.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R742.9

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