[1]孟凡飞,罗小舸,熊 琦,等.抗N- 甲基-D- 天冬氨酸受体脑炎的筛查及临床分析[J].现代检验医学杂志,2020,35(01):29-31.[doi:10.3969/j.issn.1671-7414.2020.01.008]
　MENG Fan-fei,LUO Xiao-ge,XIONG Qi,et al.Screening and Clinical Analysis of Anti-N-Methyl-D-AspartateReceptor Encephalitis[J].Journal of Modern Laboratory Medicine,2020,35(01):29-31.[doi:10.3969/j.issn.1671-7414.2020.01.008]
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抗N- 甲基-D- 天冬氨酸受体脑炎的筛查及临床分析()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第35卷
期数:
2020年01期
页码:
29-31
栏目:
论　　著
出版日期:
2020-02-29

文章信息/Info

Title:
Screening and Clinical Analysis of Anti-N-Methyl-D-Aspartate Receptor Encephalitis
文章编号:
1671-7414(2020)01-029-03
作者:
孟凡飞; 罗小舸; 熊 琦; 吴杰红
(陆军军医大学第二附属医院检验科, 重庆 400037)
Author(s):
MENG Fan-fei; LUO Xiao-ge; XIONG Qi; WU Jie-hong
(Department of Clinical Laboratory, the Second Affiliated Hospital of Army Medical University,Chongqing 400037,China)
关键词:
抗N-甲基-D-天冬氨酸受体脑炎;  临床表现;  脑脊液
分类号:
R512.3; R392.11
DOI:
10.3969/j.issn.1671-7414.2020.01.008
文献标志码:
A
摘要:
目的 分析不明原因脑炎患者的脑脊液及血清学相关参数,探讨抗N-甲基-D-天冬氨酸受体(N-methyl-D-aspartate receptor,NMDAR)脑炎在不明原因脑炎中的患病比例和临床特点。方法 收集2017年1月～2018年12月就诊入院的128例不明原因脑炎的病例资料,对患者脑脊液标本进行抗NMDAR抗体、常规及生化检测,对血清标本进行抗NMDAR抗体和肿瘤标志物检测,对筛选结果及确诊为抗NMDAR脑炎患者的临床资料进行分析。结果 128例不明原因脑炎患者,脑脊液抗NMDAR抗体阳性22例(17.2%),脑脊液常规及生化分析阳性42例(32.8%),血清抗体阳性20例(15.6%),肿瘤标志物检测阳性7例(5.5%)。确诊抗NMDAR脑炎患者22例,其中血清抗NMDAR抗体检测阳性率90.9%,脑脊液抗体阳性率100%,脑脊液常规及生化分析阳性率77.3%,肿瘤标志物检测阳性率为9.1%。确诊患者临床表现多为精神行为异常和癫痫样发作; 脑电图异常多为双额、颞、中央导联为慢波。颅脑磁共振成像(MRI)多为额颞叶T2加权像及液体衰减反转恢复序列异常信号,部分显示双侧或单侧颞角扩大。结论 脑脊液抗NMDAR抗体检查是确诊抗NMDAR脑炎的金标准,不明病因脑炎患者结合临床症状进行相关检测,对抗NMDAR脑炎的早期确诊有重要意义。
Abstract:
Objective To analyze the cerebrospinal fluid and serological parameters of patients with unexplained encephalitis, and explore the prevalence and clinical characteristics of anti-N-methyl-D-aspartate receptor(NMDAR)encephalitis in unexplained encephalitis. Methods 128 cases of unexplained encephalitis from January 2017 to December 2018 were collected. Anti-NMDAR antibodies, routine and biochemical tests were performed on cerebrospinal fluid samples. Serum samples and tumor markers were detected. The screening results and clinical data of patients diagnosed as anti-NMDAR encephalitis were analyzed. Results Anti-NMDAR antibodies were detected in cerebrospinal fluid of 128 patients with unexplained encephalitis. 22 cases(17.2%)were positive for anti-NMDAR antibodies, 42 cases(32.8%)were positive for routine and biochemical analysis of cerebrospinal fluid, 20 cases(15.6%)were positive for serum antibodies, and 7 cases(5.5%)were positive for tumor markers.22 patients with anti-NMDAR encephalitis were diagnosed, the positive rate of anti-NMDAR antibody in serum antibody was 90.9%, cerebrospinal fluid was 100%, the positive rate of routine and biochemical analysis of cerebrospinal fluid was 77.3%, and the positive rate of tumor markers was 9.1%. The clinical manifestations of the patients were mostly psychiatric symptoms and epileptic seizures, and the abnormalities of EEG were mainly bilateral frontal, temporal and central leads with slow waves. Brain magnetic resonance imaging(MRI)showed abnormal manifestations, mostly frontotemporal T2-weighted images and fluid attenuation inversion recovery sequence abnormal signals, part of which showed bilateral or unilateral temporal angle enlargement. Conclusion Anti-NMDAR antibody test in cerebrospinal fluid is the gold standard for the diagnosis of anti-NMDAR encephalitis. It is important to detect the clinical symptoms of patients with unexplained encephalitis in order to prevent the early diagnosis of NMDAR encephalitis.

参考文献/References:

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备注/Memo

备注/Memo:
基金项目:重庆市社会民生科技创新基金(自身免疫病相关抗体在脑炎诊断中的临床应用,项目编号:cstc2015shmszx120111。 作者简介:孟凡飞(1985-),男,本科,主管技师,研究方向:适配体的筛选及电化学传感器的制备,E-mail:mff00l@163.com。 通讯作者:吴杰红,教授,从事临床生化研究,E-mail:420027618@qq.com。收稿日期:2019-10-10 修回日期:2019-10-25
更新日期/Last Update: 2020-03-30