国内抗富亮氨酸胶质瘤灭活蛋白1抗体脑炎的临床特征分析  

Analysis of clinical characteristics of anti-leucine-rich glioma inactivated protein 1 antibody encephalitis in China

作　　者：陈燕玲 杜景卫[1] 徐光军[1] 梁阳阳 CHEN Yanling;DU Jingwei;XU Guangjun;LIANG Yangyang(Liaocheng People's Hospital,Liaocheng 252000,China)

机构地区：[1]聊城市人民医院,山东聊城252000

出　　处：《临床医学研究与实践》2024年第18期86-89,共4页Clinical Research and Practice

摘　　要：目的探讨国内抗富亮氨酸胶质瘤灭活蛋白1(LGI1)抗体脑炎的临床特征、治疗及预后。方法在回顾我院1例确诊为抗LGI1抗体脑炎患者病历资料的基础上,对中国生物医学文献数据库、中国知网及万方数据库检索获得的2013—2023年国内核心期刊公开报道确诊的452例抗LGI1抗体脑炎患者的临床资料进行汇总分析。结果抗LGI1抗体脑炎患者的首发症状发生率最高的是癫痫发作,依次为记忆力减退、精神行为异常及其他症状;主要症状中的癫痫发作以面臂肌张力障碍发作(FBDS)、部分性发作及强直阵挛发作为表现。部分患者合并低钠血症。MRI主要显示颞叶内侧、海马、基底神经节和岛叶异常信号。大多数患者的血清和/或脑脊液LGI1抗体检测呈阳性。多数患者免疫球蛋白和/或类固醇治疗有效,少部分需要长期口服免疫抑制剂,一般预后良好。结论抗LGI1抗体脑炎最常见症状是癫痫发作、记忆力减退以及精神行为异常。血清抗LGI1抗体阳性率高于脑脊液。脑MRI多为颞叶异常信号。尽管部分患者可能在短期内复发,但经免疫治疗一般预后良好。Objective To investigate the clinical features,treatment and prognosis of anti-leucine-rich glioma inactivated protein 1(LGI1)antibody encephalitis in China.Methods On the basis of reviewing the medical records of one patient diagnosed with anti-LGI1 antibody encephalitis in our hospital,the clinical data of 452 patients diagnosed with anti-LGI1 antibody encephalitis reported publicly in domestic core journals from 2013 to 2023 were summarized and analyzed from the Chinese Biomedical Literature Database,China National Knowledge Infrastructure and Wanfang database.Results The highest incidence of first symptoms in anti-LGI1 antibody encephalitis patients was seizures,followed by memory loss,mental and behavioral abnormalities and other symptoms;epileptic seizures was characterized by faciobrachial dystonic seizures(FBDS),partial seizures and tonic clonic seizures.Some patients had hyponatremia.MRI mainly showed abnormal signals in the medial temporal lobe,hippocampus,basal ganglia and insular lobe.Serum and/or cerebrospinal fluid LGI1 antibodies were positive in most patients.Immunoglobulin and/or steroid therapy was effective in most patients,a small number of patients needed long-term oral immunosuppressive agents,and the prognosis was generally good.Conclusion The most common symptoms of anti-LGI1 antibody encephalitis are seizures,memory loss,mental and behavioral abnormalities.The positive rate of serum anti-LGI1 antibody was higher than that of cerebrospinal fluid.Brain MRI mostly shows abnormal signals in the temporal lobe.Although some patients may relapse in the short term,the prognosis is generally good after immunotherapy.

关 键 词：抗富亮氨酸胶质瘤灭活蛋白1抗体 脑炎 癫痫 认知障碍 免疫治疗 预后 

分 类 号：R512.3[医药卫生—内科学]