自身免疫性脑炎患者的脑电图阳性表达及临床症状分析  

Positive electroencephalogram expression and clinical symptom analysis in patients with autoimmune encephalitis

作　　者：吴伟博[1] 郭丽冰[1] 杜韵华[1] WU Wei-bo;GUO Li-bing;DU Yun-hua(Department of Neurology,Foshan Third People′s Hospital,Guangdong Procvince,Foshan528041,China)

机构地区：[1]广东省佛山市第三人民医院神经内科,广东佛山528041

出　　处：《中国当代医药》2020年第31期69-72,共4页China Modern Medicine

基　　金：广东省佛山市自筹经费类科技计划项目(2017AB002251)。

摘　　要：目的探讨自身免疫性脑炎(AE)患者的脑电图阳性表达及临床症状特征。方法选取本院和三九脑科医院、佛山市第一人民医院2017年1月~2019年7月收治的31例AE患者作为观察组;另选取同时期的30例其他类型脑炎患者作为对照组。按照不同的抗神经细胞表面抗原抗体将观察组患者分为N-甲基-D-天冬氨酸受体(NMDA)组(22例)和边缘性脑炎(LE)组(9例)。采用脑电图观察患者病变情况,比较NMDA组与LE组患者的抗体阳性结果及临床症状发生情况,分析观察组与对照组的脑电图表现情况。结果NMDA组的脑脊液抗体阳性率为100.00%,血清抗体阳性率为72.73%;LE组的脑脊液抗体阳性率为100.00%,血清抗体阳性率为66.67%,两组的脑脊液抗体阳性及血清抗体阳性率比较,差异无统计学意义(P>0.05)。精神行为异常、癫痫发作、不自主运动及发热等为AE患者的主要临床症状。NMDA组患者的不自主运动和发热症状发生率高于LE组,差异有统计学意义(P<0.05);两组的精神行为异常、癫痫发作、肌强直、中枢性低通气、头痛、顽固性呕吐、肢体麻木、意识障碍、自主神经功能障碍、认知功能障碍症状发生率比较,差异无统计学意义(P>0.05);观察组的脑电图表现相似性低于对照组(P<0.05)。结论AE最常见的临床症状为精神行为异常与癫痫发作,与其他类型的脑炎患者相比,AE患者的脑电图表现相似性具有一定的差异。Objective To explore the positive expression of electroencephalogram(EEG)and clinical symptoms in patients with autoimmune encephalitis(AE).Methods A total of 31 AE patients admitted to our hospital,Sanjiu Brain Hospital,and Foshan First People′s Hospital from January 2017 to July 2019 were selected as the observation group.Another 30 cases of other brain types during the same period were selected as the control group.According to different anti-nerve cell surface antigen antibodies,the observation group was further divided into the N-methyl-D-aspartate receptor(NMDA)group(n=22)and the limbic encephalitis(LE)group(n=9).The pathological changes of the patients were observed by EEG,and the positive antibody results and the occurrence of clinical symptoms were compared between the NMDA group and the LE group.The EEG performance of the observation group and the control group were compared.Results The positive rate of cerebrospinal fluid antibodies in the NMDA group was 100.00%,the positive rate of seroantibodies was 72.73%,while the positive rates of cerebrospinal fluid antibodies and seroantibodies in the LE group were 100.00%and 66.67%respectively,there were no significant differences in the positive rate of cerebrospinal fluid antibodies and seroantibodies between the two groups(P>0.05).Abnormal mental behavior,seizures,involuntary movements and fever were the main clinical symptoms in AE patients.The incidence of involuntary movements and fever symptoms in the NMDA group were higher than those in the LE group,and the differences were statistically significant(P<0.05).There were no significant differences in the incidence of mental and behavioral abnormalities,seizures,myotonia,central hypoventilation,headache,obstinate vomiting,limb numbness,consciousness disorder,autonomic nerve dysfunction and cognitive dysfunction between the two groups(P>0.05).The similarity of EEG performance in the observation group was lower than that of the control group(P<0.05).Conclusion The most common clinical symptoms of AE are men

关 键 词：自身免疫性脑炎 脑电图 临床症状 N-甲基-D-天冬氨酸 边缘性脑炎 

分 类 号：R741.04[医药卫生—神经病学与精神病学]