Shu Yaqing, Wang Yuge, Lu Tingting, Li Rui, Sun Xiaobo, Li Jing, Chang Yanyu, Hu Xueqiang, Lu Zhengqi, Qiu Wei
Department of Neurology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
Neurochem Int. 2017 Sep;108:34-39. doi: 10.1016/j.neuint.2017.02.005. Epub 2017 Feb 10.
Uric acid (UA) levels are associated with autoimmune and neurodegenerative disorders, but their relationship with anti-N-methyl-d-aspartate receptor (anti-NMDAR) encephalitis is unknown.
UA levels were evaluated in 58 patients with anti-NMDAR encephalitis, and 58 age- and sex-matched healthy controls (CTLs). Follow-up evaluations of 30 out of the 58 patients with anti-NMDAR encephalitis were conducted 3 months after admission. Modified Rankin scale (mRS) scores and clinical and cerebrospinal fluid parameters were evaluated in all anti-NMDAR encephalitis patients.
Serum UA levels were significantly lower in patients with anti-NMDAR encephalitis than those in CTLs (p < 0.001), and this was especially evident in patients with severe impairments (mRS ≥ 4 vs. <4, p = 0.004) or with limited response to treatment (vs. favourable outcome, p = 0.002). Follow-up evaluations revealed that serum UA levels normalized after treatment, with significantly increased serum UA levels (p < 0.001), and that mRS scores were significantly lower (p < 0.001) than those before treatment. In addition, serum UA levels were significantly associated with mRS scores (r = -0.463, p < 0.001).
Our results showed that serum UA levels in patients with anti-NMDAR encephalitis are reduced during attacks compared with those in CTLs, are normalized after treatment, and are associated with disease severity.
尿酸（UA）水平与自身免疫性疾病和神经退行性疾病相关，但其与抗N-甲基-D-天冬氨酸受体（抗NMDAR）脑炎的关系尚不清楚。
对58例抗NMDAR脑炎患者及58例年龄和性别匹配的健康对照者（CTLs）的UA水平进行评估。对58例抗NMDAR脑炎患者中的30例在入院3个月后进行随访评估。对所有抗NMDAR脑炎患者评估改良Rankin量表（mRS）评分以及临床和脑脊液参数。
抗NMDAR脑炎患者的血清UA水平显著低于CTLs（p<0.001），在重度损伤患者（mRS≥4与<4，p=0.004）或治疗反应有限的患者（与良好预后相比，p=0.002）中尤其明显。随访评估显示，治疗后血清UA水平恢复正常，血清UA水平显著升高（p<0.001），且mRS评分显著低于治疗前（p<0.001）。此外，血清UA水平与mRS评分显著相关（r=-0.463，p<0.001）。
我们的结果表明，与CTLs相比，抗NMDAR脑炎患者发作期间血清UA水平降低，治疗后恢复正常，且与疾病严重程度相关。
