以精神障碍为首发症状自身免疫性脑炎的临床特征  

Clinical characteristics of autoimmune encephalitis with mental disorder as the first symptom

作　　者：陈丽君[1] 王沛娣 隋毓秀[1] CHEN Li-jun;WANG Pei-di;SUI Yu-xiu(Department of Third Psychiatry Ward,Affiliated Nanjing Brain Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学附属脑科医院精神三科,210029

出　　处：《临床精神医学杂志》2021年第4期303-305,共3页Journal of Clinical Psychiatry

基　　金：国家重点研发计划精准医学研究(2017YFC0907800)。

摘　　要：目的:探讨以精神障碍为首发症状的自身免疫性脑炎(AE)的临床特征。方法:回顾性分析59例以精神症状为首发症状AE患者临床资料。结果:①共入组患者59例,占同期AE病例的57.28%;精神症状分布依次为:幻觉、妄想、行为怪异、情绪障碍;合并躯体症状37例:主要躯体症状分布依次为癫痫、癫痫合并发热、发热。②59例患者完成头颅影像学或脑电图检查,其中46例两者之一有明确异常表现;但缺乏特异性;③完成血液抗神经元抗体和脑脊液抗神经元抗体检测患者共52例,任一抗体检验阳性者30例;抗体检测灵敏度:57.69%,假阴性率:42.31%;④临床死亡1例(1.69%);智力损伤16例(27.12%)。结论:以精神障碍为首发症状的AE患者临床症状多样,详细的实验室检查对AE早期诊断上具有重要意义。Objective:To explore clinical characteristics of autoimmune encephalitis(AE)with mental disorder as the first symptom.Method:The clinical data of 59 AE patients with mental disorder as the first symptom were retrospectively analyzed.Results:①A total of 59 patients were enrolled,accounting for 57.28%of the total cases.Most mental symptoms were as follows:hallucination,delusion,strange behavior,emotional disorder;37 cases with combined somatic symptoms:the main somatic symptoms were epilepsy,epilepsy combined with fever and fever;②All of them underwent cranial imaging or electroencephalogram examination,46 of them had definite abnormal manifestations,which was lack of specificity;③Blood and cerebrospinal fluid anti-neuronal antibody of 52 patients were conducted,and 30 patients of them were tested positive for one antibody;antibody detection sensitivity:57.69%,false negative rate:42.31%;④1 cases of them were died(1.69%);16 cases of them demonstrated intelligence damage(27.12%).Conclusion:A number of clinical characteristics were identified to have potential predictive value for outcomes in AE.

关 键 词：神经系统自身免疫疾病 脑炎 精神障碍 临床特征 

分 类 号：R749[医药卫生—神经病学与精神病学]