脑脊液CXCL13、HMGB1、BAFF与抗N⁃甲基⁃D⁃天冬氨酸受体脑炎的相关性  

Correlation analysis of CXCL13,HMGB1,BAFF in cerebrospinal fluid and anti⁃N⁃methyl⁃D⁃aspartate receptor encephalitis

作　　者：曾意茹 李小晶 吴汶霖 侯池 吴文晓 ZENG Yiru;LI Xiaojing;WU Wenlin;HOU Chi;WU Wenxiao(Department of Neurology,Women and Children's Medical Center Affiliated to Guangzhou Medical University,Guangzhou,Guangdong,China,510000)

机构地区：[1]广州医科大学附属妇女儿童医疗中心神经内科,广东广州510000

出　　处：《分子诊断与治疗杂志》2024年第12期2333-2337,共5页Journal of Molecular Diagnostics and Therapy

基　　金：广州市科技计划项目(202201020619)。

摘　　要：目的探讨分析脑脊液趋化因子13(CXCL13)、高迁移率族蛋白B1(HMGB1)、B细胞活化因子(BAFF)与抗N⁃甲基⁃D⁃天冬氨酸受体(NMDAR)脑炎的相关性。方法回顾选取2021年6⁃2024年6月广州医科大学附属妇女儿童医疗中心神经内科接收的抗NMDAR脑炎患儿共计124例,根据改良Rankin量表(mRS)评分分为轻症组68例及重症组56例。比较两组脑脊液CXCL13、HMGB1、BAFF水平,通过多因素Logistic回归分析影响抗NMDAR脑炎患者病情的相关因素;治疗1个月后根据mRS评分分为短期预后良好组72例及短期预后不良组52例,比较两组脑脊液CXCL13、HMGB1、BAFF水平,绘制ROC曲线分析CXCL13、HMGB1、BAFF与抗NMDAR脑炎患者短期预后的评估价值。结果重症组脑脊液抗NMAR高滴度比例、病程中累积出现症状次数及脑脊液CXCL13、HMGB1、BAFF水平均高于轻症组,差异均有统计学意义(P<0.05);抗NMAR滴度、病程中累积出现症状次数及脑脊液CXCL13、HMGB1、BAFF水平均与抗NMDAR脑炎患者病情的严重程度独立相关(P<0.05);预后不良组脑脊液CXCL13、BAFF、HMGB1水平均高于预后良好组,差异有统计学意义(P<0.05)。CXCL13、HMGB1、BAFF联合检测评估NMDAR预后不良的AUC为0.959,均高于单一检测(P<0.05)。结论脑脊液CXCL13、HMGB1、BAFF与抗NMDAR脑炎病情及短期预后密切相关,三者对评估抗NMDAR脑炎短期预后具有较高的预测价值。Objective To investigate the correlation between chemokine 13(CXCL13),high mobility group protein B1(HMGB1),B cell activating factor(BAFF)in cerebrospinal fluid and anti-N-methyl-D-aspartate receptor(NMDAR)encephalitis.Methods A total of 124 children with anti-NMDAR encephalitis were admitted to the Department of Neurology of Guangzhou Women and Childrens Medical Center,Guang-zhou Medical University from June 2021 to June 2024.They were retrospectively selected and divided into two groups:a mild group(68 cases)and a severe group(56 cases)based on the modified Rankin scale(mRS)score.The levels of CXCL13,HMGB1,and BAFF in the cerebrospinal fluid of the two groups were compared,and the related factors affecting the condition of patients with anti-NMDAR encephalitis were analyzed using multivariate logistic regression.After 1 month of treatment,72 cases were categorized into a group with a good short-term prognosis,while 52 cases classified into a group with a poor short-term prognosis based on their mRS scores.The levels of CXCL13,HMGB1,and BAFF in the cerebrospinal fluid of these two groups were compared,and ROC curves were generated to assess the predictive value of CXCL13,HMGB1,and BAFF for short-term prognosis in patients with anti-NMDAR encephalitis.Results The proportion of anti-NMDAR high titer,the cumulative number of symptoms during the course of the disease and the levels of CXCL13,HMGB1,and BAFF in CSF were higher in the severe group compared to the mild group,with sta-tistical significance(P<0.05).The anti-NMDAR titer,the cumulative number of symptoms during the course of the disease and the levels of CXCL13,HMGB1,and BAFF in cerebrospinal fluid were independently corre-lated with the severity of the disease in patients with anti-NMDAR encephalitis(P<0.05).The levels of CXCL13,BAFF,and HMGB1 in cerebrospinal fluid in the poor prognosis group were higher than those in the good prognosis group,and the differences were statistically significant(P<0.05).The AUC of CXCL13,HMGB1,and BAFF in evaluating the poor

关 键 词：脑脊液趋化因子13 高迁移率族蛋白B1 B细胞活化因子 抗N⁃甲基⁃D⁃天冬氨酸受体 脑炎 

分 类 号：R742.9[医药卫生—神经病学与精神病学]