王新;肖洪波;

• 1:辽宁省鞍山市中心医院铁东院区神经内二科

摘要(Abstract)：

目的对14例自身免疫性脑炎病例进行分析,为临床诊治提供参考。方法对2017年8月至2018年8月在我院诊治的自身免疫性脑炎病例进行回顾性分析,并结合文献进行讨论。结果 14例患者中,男9例,女5例,发病年龄36～85岁,平均56岁,其中二缩氨酸相似蛋白-6脑炎(DPPX脑炎)4例,抗γ-氨基丁酸B型受体(Gamma aminobutyric acid type B receptor,GABABR)脑炎4例,抗富含亮氨酸胶质瘤失活蛋白1(Leucine-rich glioma-inactivated,LGI1)脑炎6例,治疗主要以甲泼尼龙冲击、大剂量免疫球蛋白、抗癫痫药物治疗、抗精神病药物为主。3例患者在随访中死亡,2例死于肺癌,1例为心律失常猝死。其他患者预后良好。结论自身免疫性脑炎预后良好,早期激素联合人免疫球蛋白治疗、积极治疗合并的肿瘤,对于控制症状、改善预后具有重要意义。

关键词(KeyWords)： 自身免疫性脑炎;癫痫;认知功能障碍

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 王新;肖洪波;

Email:

DOI: 10.14053/j.cnki.ppcr.202101013

参考文献(References)：

• [1] Britton J.Autoimmune epilepsy [J].Hand b Clin- Neurol,2016,133:219-245.
• [2] 陈向军,邓波.自身免疫性脑炎的诊断标准及指导意义[J].中国临床神经病学,2016,24:336-440.
• [3] 中华医学会神经病学分会.中国自身免疫性脑炎诊治专家共识[J].中华神经科学杂志,2017,50:91-98.
• [4] 脱厚珍,田泽龙,薛云,等.抗富亮氨酸胶质瘤失活 1蛋白抗体相关性边缘叶脑炎4 例临床分析和文献复习[J].临床和实验医学杂志,2018,17(11):1141-1144.
• [5] Byun JI,Lee ST,Jung KH,et al.Effect of immunotherapy on seizure outcome in patients with autoimmune encephalitis:a prospective observational registry study [J].PLoS One,2016,11:e146455.
• [6] Singh TD,Fugate JE,Hocker SE,et al.Postence phalitic epilepsy:clinical characteristics and predictors[J].Epilepsia,2015,56:133-138.
• [7] Dogan OM,Deuretzbacher D,Haensch CA,et al.Limbic encephalitis due to GABAB and AMPA receptor antibodies:acase series[J].J Neurol Neurosurg Psychiatry,2015,86(9):965-972.
• [8] 吴颖颖,杨辉丽,雷高凡,等.抗γ-氨基丁酸B型受体脑炎患者五例临床分析[J].中华老年医学杂志,2016,35(11):1160-1163.
• [9] Dubey D,Alqal laf A,Hays R,et al.Neurological autoantibody prevalence in epilepsy of unknown etiology [J].JAMA Neurol,2017,74:397-402.
• [10] Malter MP,Frisch C,Schoene Bake JC,et al.Outcome of limbic encephalitis with VGKC-complex antibodies:relation to antigenic specificity [J].J Neurol,2014,261(9):1695-1705.
• [11] Guan HZ,Ren HT,Yang XZ,et al.Limbic encephalitis associated with anti-γ-aminobutyric Acid B receptor antibodies:a case series from China[J].Chin Med J (Engl),2015,128(22):3023-3028.
• [12] Leypoldt F,Armangue T,Dalmau J.Autoimmune encephalopathies[J].Ann N YAcad Sci,2015,1338:94-114.
• [13] Chen X,Liu F,Li JM,et al.Encephalitis with antibodies against the GABAB receptor:seizures as the most common presentation at admission[J].Neurol Res,2017,39(11):973-980.
• [14] Petit-Pedrol M,Sell J,Planagumà J,et al.LGI1 antibodies alter Kv1.1 and AMPA receptors changing synaptic excitabili-ty,plasticity and memory [J].Brain,2018,141(11):3144-3159.
• [15] Quek AM,Britton JW,McKeon A,et al.Autoimmune epilepsy.clinical characteristics and response to immunotherapy[J].Arch Neurol,2012,69:582-593.