抗N-甲基-D-天门冬氨酸受体脑炎的临床分析
发布时间：2018-08-17 11:24
【摘要】：目的探讨抗N-甲基-D-天门冬氨酸受体脑炎的临床疗效。方法选择我院及宣武医院2013年4月-2015年12月收治的53例抗N-甲基-D-天门冬氨酸受体脑炎患者作为研究对象,对其人口学资料、病史、临床表现、实验室检查、影像学检查以及治疗效果等多方面的资料进行回顾性分析。结果抗N-甲基-D-天门冬氨酸受体脑炎患者在疾病初期、发展过程以及病程后期的临床表现不一,且逐步严重,疾病初期以精神行为异常尤为常见、发展过程则以癫痫发作较为常见、病程后期则是以运动障碍和自主神经功能障碍尤为常见;多数患者的脑脊液实验室检查异常,主要表现为白细胞、蛋白升高等;53例中48例患者脑电图检查异常,主要发生在颞、额、顶部。结论抗N-甲基-D-天门冬氨酸受体脑炎早期并无特异性表现,容易出现误诊,诊断时应结合患者的临床表现、实验室辅助检查和脑脊液抗N-甲基-D-天门冬氨酸受体抗体检测等结果综合分析,以减少早期误诊率,改善预后。
[Abstract]:Objective to investigate the clinical effect of anti-N-methyl-d-aspartate receptor encephalitis. Methods 53 patients with N- methyl-Daspartate receptor encephalitis were selected from our hospital and Xuanwu Hospital from April 2013 to December 2015. The imaging examination and therapeutic effect were analyzed retrospectively. Results the clinical manifestations of the patients with anti-N- methyl-Daspartate receptor encephalitis were different in the early stage of the disease, the development process and the late stage of the disease, and the clinical manifestations were serious, especially in the early stage of the disease. Epileptic seizures are more common in the development process, motor disorders and autonomic nervous dysfunction are more common in the later stage of the disease, and most of the patients have abnormal cerebrospinal fluid laboratory examination, mainly manifested as white blood cells. Of 53 patients with elevated protein, 48 had abnormal EEG, mainly in temporal, frontal and parietal areas. Conclusion Anti-N- methyl-Daspartic acid receptor encephalitis has no specific manifestations at the early stage and is prone to misdiagnosis. The diagnosis should be combined with the clinical manifestations of the patients. The results of laboratory assistant examination and cerebrospinal fluid anti-N- methyl-Daspartic acid receptor antibody were analyzed in order to reduce the rate of early misdiagnosis and improve the prognosis.
【作者单位】： 辽宁省鞍山市第三医院神经内科;首都医科大学宣武医院神经内科;
【分类号】：R742.9
本文编号：2187477
[Abstract]:Objective to investigate the clinical effect of anti-N-methyl-d-aspartate receptor encephalitis. Methods 53 patients with N- methyl-Daspartate receptor encephalitis were selected from our hospital and Xuanwu Hospital from April 2013 to December 2015. The imaging examination and therapeutic effect were analyzed retrospectively. Results the clinical manifestations of the patients with anti-N- methyl-Daspartate receptor encephalitis were different in the early stage of the disease, the development process and the late stage of the disease, and the clinical manifestations were serious, especially in the early stage of the disease. Epileptic seizures are more common in the development process, motor disorders and autonomic nervous dysfunction are more common in the later stage of the disease, and most of the patients have abnormal cerebrospinal fluid laboratory examination, mainly manifested as white blood cells. Of 53 patients with elevated protein, 48 had abnormal EEG, mainly in temporal, frontal and parietal areas. Conclusion Anti-N- methyl-Daspartic acid receptor encephalitis has no specific manifestations at the early stage and is prone to misdiagnosis. The diagnosis should be combined with the clinical manifestations of the patients. The results of laboratory assistant examination and cerebrospinal fluid anti-N- methyl-Daspartic acid receptor antibody were analyzed in order to reduce the rate of early misdiagnosis and improve the prognosis.
【作者单位】： 辽宁省鞍山市第三医院神经内科;首都医科大学宣武医院神经内科;
【分类号】：R742.9
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