Tianjin Children's Hospital (Tianjin University Children's Hospital), Tianjin, 300134, China.
Department of Institute of Pediatrics, Tianjin Children's Hospital, Tianjin, 300134, China.
Ital J Pediatr. 2022 Jun 13;48(1):94. doi: 10.1186/s13052-022-01247-0.
Autoimmune encephalitis (AE) is a type of encephalopathy mediated by an antigenic immune response in the central nervous system. Most research related to autoimmune encephalitis (AE) is focused on early diagnosis, treatment and prognosis analysis; there has been little research conducted on the characteristics of immune function, and the relationship between immune function and prognoses of patients with autoimmune encephalitis needs to be studied further.
A total of 33 children with autoimmune encephalitis were identified through the clinic database and inpatient consults at Tianjin Children's Hospital from January 2013 to January 2021. Based on the one-year follow-up and the modified Rankin Scale (mRS) prognosis score, they were divided into a good prognosis group and a poor prognosis group. The immune function characteristics of the two groups of children with autoimmune encephalitis (AE) were compared using Spearman correlation to analyse the mRS score and immune function indicators (IgA, IgG, IgM, CD4, CD8, CD4/CD8), and binary logistic regression was used to analyse the independent risk factors of the prognoses in patients with autoimmune encephalitis (AE).
The differences in abnormal mental disorders and limb dyskinesia, cognitive impairment, onset types, modified Rankin Scale (mRS) scores at admission, and immune function status during remission between the two groups were statistically significant (p < 0.05).
There is a close correlation between modified Rankin Scale (mRS) scores and the immune function index CD4/CD8 in children with autoimmune encephalitis (AE) when they are admitted to the hospital. A young age, disturbance of consciousness, limb dyskinesia, abnormal immune function in remission and anti-NMDAR encephalitis are risk factors for poor prognoses in children with autoimmune encephalitis (AE). Clinical treatment requires more attention.
自身免疫性脑炎（AE）是一种由中枢神经系统抗原免疫反应介导的脑病。大多数与自身免疫性脑炎（AE）相关的研究都集中在早期诊断、治疗和预后分析上；对免疫功能的特征研究较少，需要进一步研究免疫功能与自身免疫性脑炎患者预后的关系。
通过天津儿童医院的临床数据库和住院会诊，从 2013 年 1 月至 2021 年 1 月共确定了 33 例自身免疫性脑炎患儿。根据一年的随访和改良 Rankin 量表（mRS）预后评分，将他们分为预后良好组和预后不良组。采用 Spearman 相关分析比较两组自身免疫性脑炎患儿（AE）的免疫功能特征，分析 mRS 评分与免疫功能指标（IgA、IgG、IgM、CD4、CD8、CD4/CD8）的关系，采用二项逻辑回归分析自身免疫性脑炎（AE）患者预后的独立危险因素。
两组患儿在异常精神障碍和肢体运动障碍、认知障碍、发病类型、入院时改良 Rankin 量表（mRS）评分、缓解期免疫功能状态方面的差异有统计学意义（p<0.05）。
自身免疫性脑炎（AE）患儿入院时 mRS 评分与免疫功能指标 CD4/CD8 密切相关。年龄较小、意识障碍、肢体运动障碍、缓解期免疫功能异常和抗 NMDAR 脑炎是自身免疫性脑炎（AE）患儿预后不良的危险因素。临床治疗需要更加重视。
