Yuan Ping-Qiao, Li Jia, Zhang Le, Li Jin-Mei, Li Yin-Ping, Yang Rong
Department of Neurology,West China Hospital,Sichuan University,Chengdu 610041, China.
Sichuan Da Xue Xue Bao Yi Xue Ban. 2018 Nov;49(6):979-982.
To investigate the clinical manifestations and complications in the patients of anti-N-methyl-D-aspartate (anti-NMDA) receptor encephalitis.
We retrospectively collected clinical data of 143 patients diagnosed with anti-NMDA receptor encephalitis. According to the complexity of clinical symptoms, the patients were divided into two groups: ≥4 clinical symptoms group (96 cases, 67.1%) and <4 group (47 cases, 32.9%). There were 109 patients with complications and 34 patients without any complicaitons, The related factors to symptom complexity and complications were analyzed by univariate and multivariate analysis method.
In the 143 patients of anti-NMDA receptor encephalitis, 120 (83.9%) exhibited seizures, 130 (90.9%) presented with psychiatric symptoms. Pulmonary infections (58.7%) and gastrointestinal disorders (49.0%) were the most common complications. Univariate analysis showed that the complexity of clinical symptoms was related to abnormal electroencephalography (EEG), positive anti-NMDA receptor antibody in cerebrospinal fluid(CSF) and serum. There were more frequent seizures, disorders of consciousness, abnormal movements, central hypoventilation in the patients with complications than those in patients without complications, all the differences were signifcant (<0.05). Multivariate analysis showed that abnormal EEG was an independent risk factor for symptom complexity 〔odds ratio()=2.620, <0.05〕. The abnormal movements and the activities of daily living (ADL) on admission were predictor factors for the incidence of complications (=4.338, 0.980, respectively, <0.05).
In the patients of anti-NMDA receptor encephalitis, abnormal EEG may related to more complex clinical symptoms. Abnormal movements and low ADL on admission seems to be independent risk factors related to the incidence of complications.
探讨抗N-甲基-D-天冬氨酸（抗-NMDA）受体脑炎患者的临床表现及并发症。
回顾性收集143例诊断为抗-NMDA受体脑炎患者的临床资料。根据临床症状的复杂程度，将患者分为两组：≥4种临床症状组（96例，67.1%）和<4种临床症状组（47例，32.9%）。有109例患者出现并发症，34例患者无任何并发症，采用单因素和多因素分析方法分析症状复杂程度和并发症的相关因素。
在143例抗-NMDA受体脑炎患者中，120例（83.9%）出现癫痫发作，130例（90.9%）出现精神症状。肺部感染（58.7%）和胃肠道紊乱（49.0%）是最常见的并发症。单因素分析显示，临床症状的复杂程度与脑电图（EEG）异常、脑脊液（CSF）和血清中抗-NMDA受体抗体阳性有关。有并发症的患者比无并发症的患者癫痫发作更频繁、意识障碍、异常运动、中枢性通气不足，所有差异均有统计学意义（<0.05）。多因素分析显示，EEG异常是症状复杂程度的独立危险因素〔比值比（OR）=2.620，<0.05〕。异常运动和入院时的日常生活活动能力（ADL）是并发症发生率的预测因素（分别为OR=4.338，0.980，<0.05）。
在抗-NMDA受体脑炎患者中，EEG异常可能与更复杂的临床症状有关。入院时异常运动和低ADL似乎是与并发症发生率相关的独立危险因素。
