抗富亮氨酸胶质瘤灭活蛋白1抗体脑炎血清抗体滴度与临床特点及预后相关性研究  

Correlation of serum antibody titers with clinical features and prognosis of anti leucine-rich glioma inactivated 1 antibody encephalitis

作　　者：董赞 张方 王婧[1] 王洁[1] Dong Zan;Zhang Fang;Wang Jing;Wang Jie(Department of Neurology,the First Hospital of Shanxi Medical University,Taiyuan 030001,China;Department of Neurology,Taizhou Hospital of Chinese Medicine,Taizhou 318000,China)

机构地区：[1]山西医科大学第一医院神经内科,太原030001 [2]台州市中医院神经内科,台州318000

出　　处：《中华神经科杂志》2023年第7期738-746,共9页Chinese Journal of Neurology

摘　　要：目的分析抗富亮氨酸胶质瘤灭活蛋白1(LGI1)抗体脑炎患者血清抗体滴度与其临床特点及预后之间的关系。方法收集2015年2月至2021年2月于山西医科大学第一医院神经内科确诊为脑炎的20例患者的临床资料并进行回顾性分析。依据患者血清抗LGI1抗体滴度将患者分为两组,分别为高滴度组(1∶100、1∶320)及低滴度组(1∶10、1∶32),比较两组患者的临床特征、实验室检查结果及预后情况。结果20例抗LGI1抗体脑炎患者的年龄为27~69(53.5±11.2)岁,男女比例为1∶1。其中低滴度组患者9例,高滴度组患者11例,两组患者在临床症状的种类及数量上无明显差别。高滴度组患者的头颅磁共振成像更易出现异常病灶(10/11比3/9,P=0.014)。两组患者的脑脊液抗LGI1抗体阳性比例差异无统计学意义(9/11比4/9,P=0.160)。随访时发现20例患者中有1例患者死于肺栓塞,7/20的患者可恢复至病前状态,9/20的患者遗留记忆力减退。高滴度组患者有3/11病情复发,低滴度组无一例复发。出院3个月及长期随访时两组患者的神经功能预后差异无统计学意义(改良Rankin量表评分≤2分的患者比例:10/10比/8/9,P=0.474)。结论血清抗LGI1抗体高滴度的患者更易出现脑内病灶。较高抗体滴度可能与疾病复发的高风险有关。血清抗体滴度与患者的神经功能预后无明显相关。Objective To analyze the relationship between serum antibody titers,clinical characteristics,and prognosis in patients with encephalitis induced by anti leucine-rich glioma inactivated 1(LGI1)antibody.Methods Clinical data of 20 patients diagnosed with encephalitis in the Department of Neurology,First Hospital of Shanxi Medical University from February 2015 to February 2021 were collected and retrospectively analyzed.Patients were divided into 2 groups based on their serum anti LGI1 antibody titers,namely the high titer group(1∶100,1∶320)and the low titer group(1∶10,1∶32).The clinical characteristics,laboratory test results,and prognosis of the 2 groups of patients were compared.Relusts The age of the 20 patients with anti LGI1 antibody encephalitis ranged from 27 to 69(53.5±11.2)years,with a male to female ratio of 1∶1.There were 9 patients in the low titer group and 11 patients in the high titer group.There was no statistically significant difference in the types and quantities of clinical symptoms between the 2 groups.Patients in the high titer group were more prone to abnormal lesions on cranial magnetic resonance imaging(10/11 vs 3/9,P=0.014).There was no statistically significant difference between the 2 groups in the presence or absence of cerebrospinal fluid anti LGI1 antibodies(9/11vs 4/9,P=0.160).During the follow-up,it was found that 1/20 patient died of pulmonary embolism,7/20 of patients were able to recover to their predisease state,and 9/20 of patients had residual memory impairment.In the high titer group,3/11 of patients experienced recurrence,while there was no recurrence in the low titer group.There was no statistically significant difference in the neurological prognosis between the 2 groups at 3 months of discharge and follow-up(the number of patients whose modified Rankin Scale score≤2:10/10vs 8/9,P=0.474).Conclusion sPatients with high serum anti LGI1 antibody titers are more likely to develop intracerebral lesions.Higher antibody titers may be associated with a higher risk of

关 键 词：抗富亮氨酸胶质瘤失活蛋白-1 脑炎 免疫治疗 预后 

分 类 号：R742.9[医药卫生—神经病学与精神病学]