自身免疫性脑炎患者合并认知功能障碍的风险因素分析  

Analysis of risk factors for cognitive dysfunction in patients with autoimmune encephalitis

作　　者：安清明 张亮银 张毅[3] AN Qingming;ZHANG Liangyin;ZHANG Yi(Gansu University of Chinese Medicine,Lanzhou 730101;the First People's Hospital of Baiyin,Baiyin 730900;Gansu Provincial Hospital,Lanzhou 730000,China)

机构地区：[1]甘肃中医药大学,甘肃兰州730101 [2]白银市第一人民医院,甘肃白银730900 [3]甘肃省人民医院,甘肃兰州730000

出　　处：《临床医学研究与实践》2025年第5期17-20,共4页Clinical Research and Practice

摘　　要：目的探究自身免疫性脑炎患者合并认知功能障碍的风险因素。方法选取2021年10月至2022年10月神经内科82例自身免疫性脑炎患者,采用24 h蒙特利尔认知评估量表(MoCA)进行评估,将评分<26分的患者作为观察组(n=34,合并认知功能障碍),评分≥26分的患者作为对照组(n=48,未合并认知功能障碍)。所有患者经血清及脑脊液相关抗体检测分型为55例抗NMDAR抗体脑炎、18例抗GABABR抗体脑炎、9例抗LGI1抗体脑炎。比较不同亚型自身免疫性脑炎患者的一般人口统计学资料;比较自身免疫性脑炎患者的临床资料;通过多因素Logistic回归模型分析影响自身免疫性脑炎合并认知功能障碍的相关因素。结果抗NMDAR抗体脑炎患者的平均年龄显著小于抗GABABR、抗LGI1抗体,差异具有统计学意义(P<0.001)。观察组的年龄大于对照组,合并肿瘤、癫痫发作发生率显著高于对照组,差异具有统计学意义(P<0.05)。多因素Logistic回归结果显示,年龄[OR(95%CI)=1.19(1.01~3.05)]、合并肿瘤[OR(95%CI)=1.41(1.10~4.98)]、癫痫发作[OR(95%CI)=2.24(1.12~6.89)]是影响自身免疫性脑炎合并认知功能障碍的相关因素(P<0.05)。结论自身免疫性脑炎中认知功能障碍发生率高,年龄、合并肿瘤、癫痫发作是其相关因素。Objective To explore the risk factors of cognitive dysfunction in patients with autoimmune encephalitis.Methods A total of 82 patients with autoimmune encephalitis in the neurology department from October 2021 to October 2022 were selected for evaluation using the 24 h Montreal Cognitive Assessment Scale(MoCA).Patients with a score of<26 were used as observation group(n=34,combined with cognitive dysfunction),and patients with a score of≥26 were used as control group(n=48,not combined with cognitive dysfunction).All patients were divided into 55 cases of anti-NMDAR antibody encephalitis,18 cases of anti-GABABR antibody encephalitis and 9 cases of anti-LGI1 antibody encephalitis by serum and cerebrospinal fluid related antibody detection.The general demographic data of patients with different subtypes of autoimmune encephalitis were compared;the clinical data of patients with autoimmune encephalitis were compared;the related factors affecting autoimmune encephalitis complicated with cognitive dysfunction were analyzed by multivariate Logistic regression model.Results The average age of patients with anti-NMDAR antibody encephalitis was significantly lower than that of anti-GABABR and anti-LGI1 antibodies,and the difference was statistically significant(P<0.001).The age of the observation group was older than that of the control group,and the incidences of combined tumors and seizures were significantly higher than those of the control group,and the differences were statistically significant(P<0.05).Multivariate Logistic regression results showed that age[OR(95%CI)=1.19(1.01-3.05)],combined tumors[OR(95%CI)=1.41(1.10-4.98)],and seizures[OR(95%CI)=2.24(1.12-6.89)]were related factors affecting autoimmune encephalitis with cognitive dysfunction(P<0.05).Conclusion The incidence of cognitive dysfunction in autoimmune encephalitis is high,and age,combined tumors,and seizures are related factors.

关 键 词：抗NMDAR抗体 抗GABABR抗体 抗LGI1抗体 自身免疫性脑炎 认知功能障碍 风险因素 

分 类 号：R742.9[医药卫生—神经病学与精神病学]