抗接触蛋白相关蛋白2抗体脑炎血清抗体滴度与临床特征及预后的相关性  

Correlation between serum antibody titers of anti-contactin associated protein-like 2 antibody and clinical features and prognosis in encephalitis

作　　者：陈培[1] 祝清勇[1] 梁东晓[1] 冯方 张瑞[1] Chen Pei;Zhu Qingyong;Liang Dongxiao;Feng Fang;Zhang Rui(Department of Neurology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院神经内科,郑州450052

出　　处：《中国医师杂志》2024年第7期964-968,共5页Journal of Chinese Physician

基　　金：国家自然科学基金(82201407)。

摘　　要：目的分析抗接触蛋白相关蛋白2(CASPR2)抗体脑炎血清抗体滴度与临床特征及预后的相关性。方法回顾性分析2018年1月至2024年4月于郑州大学第一附属医院确诊的31例抗CASPR2抗体脑炎患者的临床资料。依据血清抗CASPR2抗体滴度将患者分为低滴度组(≤1:32)及高滴度组(>1:32),比较两组患者的临床特征、辅助检查结果及预后情况。结果31例抗CASPR2抗体脑炎患者(男:女=1:1.4)中,低滴度组16例,高滴度组15例;高滴度组患者年龄为(33.9±17.9)岁,低于低滴度组患者[(52.9±17.9)岁],差异有统计学意义(P=0.006)。高滴度组伴前驱期感染诱因的比例(6/15)高于低滴度组(1/16,P=0.037)。两组患者的脑脊液相关检验结果、影像学检查颅内异常病灶、异常脑电图、血清异常肿瘤标志物及血清异常风湿免疫指标比较差异均无统计学意义(均P>0.05)。住院期间,1例高滴度组患者死亡;随访期间,1例患者死亡,3例复发,均为高滴度组。6例患者随访时mRS评分为3~5分(提示功能障碍),其中高滴度组4例,低滴度组2例。高滴度组患者预后不良比例(9/15)高于低滴度组(2/16),差异有统计学意义(P=0.021)。结论血清抗CASPR2抗体高滴度脑炎患者的发病年龄偏低,易存在前驱感染诱因,较高的抗体滴度可能与疾病复发高风险相关,并与患者预后不良相关。Objective To analyze the correlation between serum antibody titers of anti-contactin associated protein-like 2(CASPR2)antibody and clinical features and prognosis in encephalitis.Methods A retrospective analysis was conducted on the clinical data of 31 patients diagnosed with anti-CASPR2 antibody encephalitis at the First Affiliated Hospital of Zhengzhou University from January 2018 to April 2024.Patients were divided into low titer group(≤1:32)and high titer group(>1:32)based on serum anti-CASPR2 antibody titers,and their clinical characteristics,auxiliary examination results,and prognosis were compared between the two groups.Results sAmong the 31 patients with anti CASPR2 antibody encephalitis(male:female=1:1.4),there were 16 cases in the low titer group and 15 cases in the high titer group;The age of patients in the high titer group was(33.9±17.9)years,which was lower than that of patients in the low titer group[(52.9±17.9)years],and the difference was statistically significant(P=0.006).The proportion of patients with prodromal infection in the high titer group(6/15)was higher than that in the low titer group(1/16,P=0.037).There was no statistically significant difference in the cerebrospinal fluid related test results,imaging examination of intracranial abnormal lesions,abnormal electroencephalogram,serum abnormal tumor markers,and serum abnormal rheumatic immune indicators between the two groups of patients(all P>0.05).During hospitalization,one patient in the high titer group died;During the follow-up period,one patient died and three patients relapsed,all of whom were in the high titer group.During follow-up,the mRS scores of 6 patients ranged from 3 to 5 points(indicating functional impairment),with 4 cases in the high titer group and 2 cases in the low titer group.The proportion of patients with poor prognosis in the high titer group(9/15)was higher than that in the low titer group(2/16),and the difference was statistically significant(P=0.021).Conclusions Patients with high serum anti-CASPR2 antibod

关 键 词：自身免疫性脑炎 自身抗体 接触蛋白相关蛋白2 

分 类 号：R741[医药卫生—神经病学与精神病学]