不同预后的富亮氨酸胶质瘤失活1蛋白抗体脑炎临床特点与影响因素  

Analysis of clinical features and influencing factors of leucine-rich glioma inactivated 1 protein antibody encephalitis with different prognosis

作　　者：高扬 李燕飞[1] 栾婷婷 张朝朋 谢皓洁 姚要兵 段冉 贾延劼[1] GAO Yang;LI Yanfei;LUAN Tingting;ZHANG Chaopeng;XIE Haojie;YAO Yaobing;DUAN Ranran;JIA Yanjie(Department of Neurology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]河南省郑州市郑州大学第一附属医院神经内科,郑州450052

出　　处：《中国神经精神疾病杂志》2020年第12期705-709,共5页Chinese Journal of Nervous and Mental Diseases

摘　　要：目的比较预后良好和预后不良的富亮氨酸胶质瘤失活1蛋白(leucine-rich glioma inactivated 1,LGI1)抗体脑炎患者临床特点并分析其影响因素。方法回顾性分析45例LGI1抗体脑炎患者的临床资料,根据末次随访的改良Rankin量表(mRS)结果分为预后良好组(mRS≤2分)和预后不良组(mRS>2分),比较两组之间的差异并运用logistic回归寻找影响预后的因素。结果纳入LGI1抗体脑炎患者45例,随访3~24个月,其中预后良好组33例,预后不良组12例。与预后良好组相比,预后不良组患者的发病年龄更大、精神行为异常发生率更高、癫痫发生率更低,且差异均有统计学意义(P<0.05)。多因素logistic回归分析显示,癫痫发作(OR=0.161,95%CI:0.031~0.840,P=0.030)是预后的显著相关因素。结论发病年龄大、精神行为异常发生率高的LGI1抗体脑炎患者预后不良,癫痫发作可能影响预后。Objective To compare the clinical characteristics of LGI1 antibody encephalitis patients with good prognosis and poor prognosis and analyze the factors affecting prognosis.Methods The clinical data of 45 patients with LGI1 antibody encephalitis were retrospectively analyzed.According to the modified Rankin Scale(mRS)scores at the last follow-up,they were divided into a good prognosis group(mRS≤2 points)and a poor prognosis group(mRS>2 points).The difference between the two groups was compared and factors affecting prognosis was analyzed using logistic regression.Results A total of 45 patients with LGI1 antibody encephalitis were enrolled and followed up for 3-24 months.Among them,33 patients were in the good prognosis group and 12 patients were in the poor prognosis group.Compared with the good prognosis group,the patients in the poor prognosis group had an older age of onset,a higher incidence of mental and behavioral abnormalities,and a lower incidence of epilepsy(P<0.05).Multivariate logistic regression analysis showed that seizure was a significantly related factor of prognosis(OR=0.161,95%CI:0.031~0.840,P=0.030).Conclusion Most of LGI1 antibody encephalitis has a good prognosis.Patients with older age onset and abnormal mental behaviors have a poor prognsosis and seizures may affect the prognosis in patients with LGI1 antibody encephalitis.

关 键 词：LGI1抗体 自身免疫性脑炎 临床表现 免疫治疗 预后 

分 类 号：R742[医药卫生—神经病学与精神病学]