抗N-甲基-D-天門冬氨酸受體腦炎的臨床分析
發(fā)布時(shí)間：2018-08-17 11:24
【摘要】：目的探討抗N-甲基-D-天門冬氨酸受體腦炎的臨床療效。方法選擇我院及宣武醫(yī)院2013年4月-2015年12月收治的53例抗N-甲基-D-天門冬氨酸受體腦炎患者作為研究對象,對其人口學(xué)資料、病史、臨床表現(xiàn)、實(shí)驗(yàn)室檢查、影像學(xué)檢查以及治療效果等多方面的資料進(jìn)行回顧性分析。結(jié)果抗N-甲基-D-天門冬氨酸受體腦炎患者在疾病初期、發(fā)展過程以及病程后期的臨床表現(xiàn)不一,且逐步嚴(yán)重,疾病初期以精神行為異常尤為常見、發(fā)展過程則以癲癇發(fā)作較為常見、病程后期則是以運(yùn)動障礙和自主神經(jīng)功能障礙尤為常見;多數(shù)患者的腦脊液實(shí)驗(yàn)室檢查異常,主要表現(xiàn)為白細(xì)胞、蛋白升高等;53例中48例患者腦電圖檢查異常,主要發(fā)生在顳、額、頂部。結(jié)論抗N-甲基-D-天門冬氨酸受體腦炎早期并無特異性表現(xiàn),容易出現(xiàn)誤診,診斷時(shí)應(yīng)結(jié)合患者的臨床表現(xiàn)、實(shí)驗(yàn)室輔助檢查和腦脊液抗N-甲基-D-天門冬氨酸受體抗體檢測等結(jié)果綜合分析,以減少早期誤診率,改善預(yù)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.
【作者單位】： 遼寧省鞍山市第三醫(yī)院神經(jīng)內(nèi)科;首都醫(yī)科大學(xué)宣武醫(yī)院神經(jīng)內(nèi)科;
【分類號】：R742.9
本文編號：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.
【作者單位】： 遼寧省鞍山市第三醫(yī)院神經(jīng)內(nèi)科;首都醫(yī)科大學(xué)宣武醫(yī)院神經(jīng)內(nèi)科;
【分類號】：R742.9
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