Wang Zhi-Hao, Qiao Shan, Wang Lei, Wang Kemo, Zhang Ranran, Jin Yang, Wu Huai-Kuan, Liu Xuewu
Department of Neurology, Qilu Hospital of Shandong University, Jinan, China.
Department of Neurology, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Jinan, China.
Front Neurol. 2023 Apr 13;14:1148450. doi: 10.3389/fneur.2023.1148450. eCollection 2023.
We aimed to investigate whether lipid profiles and homocysteine levels in patients with anti-N-methyl-D-aspartate receptor encephalitis are related to clinical presentation and prognosis, which may contribute to further research on the pathogenesis and treatment of this disease.
This study included a total of 43 patients with anti-N-methyl-D-aspartate receptor encephalitis and 43 sex-age-matched healthy controls. Baseline demography, clinical data, patient outcomes, and ancillary examination results were recorded. Patients were followed up every 2-3 months during the first year. The modified Rankin Scale score was used to evaluate the therapeutic effect and clinical outcome.
Among the 43 patients included in this study, 55.81% were male, the mean age of onset was 27 years old, and the median modified Rankin Scale score on admission was 3.0. Apolipoprotein A-1 was significantly lower in patients with anti-N-methyl-D-aspartate receptor encephalitis compared with healthy controls ( = 0.004). Compared with healthy controls, homocysteine ( = 0.002), apolipoprotein B ( = 0.004), Lpa ( = 0.045), and apolipoprotein B/apolipoprotein A-1 ( = 0.001) were significantly increased in patients with anti-N-methyl-D-aspartate receptor encephalitis. According to the modified Rankin Scale scores, 6 months after discharge, 72.09% of patients had a good prognosis and 27.91% had a poor prognosis. In the good prognosis group, age ( = 0.031), lipoprotein a ( = 0.023), apolipoprotein A-1 ( = 0.027) at baseline, and the modified Rankin Scale score on admission ( = 0.019) were significantly higher than those in the poor prognosis group.
This study suggests the possibility that serum lipid profile and homocysteine play an important role in the pathogenesis of anti-N-methyl-D-aspartate receptor encephalitis, providing support for lipid-lowering treatment of anti-N-methyl-D-aspartate receptor encephalitis patients.
我们旨在研究抗N-甲基-D-天冬氨酸受体脑炎患者的血脂谱和同型半胱氨酸水平是否与临床表现及预后相关，这可能有助于对该疾病的发病机制和治疗进行进一步研究。
本研究共纳入43例抗N-甲基-D-天冬氨酸受体脑炎患者和43例性别、年龄匹配的健康对照者。记录基线人口统计学、临床数据、患者结局及辅助检查结果。在第一年中，每2至3个月对患者进行随访。采用改良Rankin量表评分评估治疗效果和临床结局。
本研究纳入的43例患者中，55.81%为男性，平均发病年龄为27岁，入院时改良Rankin量表评分中位数为3.0。与健康对照者相比，抗N-甲基-D-天冬氨酸受体脑炎患者的载脂蛋白A-1显著降低（P = 0.004）。与健康对照者相比，抗N-甲基-D-天冬氨酸受体脑炎患者的同型半胱氨酸（P = 0.002）、载脂蛋白B（P = 0.004）、脂蛋白a（P = 0.045）及载脂蛋白B/载脂蛋白A-1（P = 0.001）显著升高。根据改良Rankin量表评分，出院6个月后，72.09%的患者预后良好，27.91%的患者预后不良。在预后良好组中，基线时的年龄（P = 0.031）、脂蛋白a（P = 0.023）、载脂蛋白A-1（P = 0.027）及入院时的改良Rankin量表评分（P = 0.019）均显著高于预后不良组。
本研究提示血清血脂谱和同型半胱氨酸在抗N-甲基-D-天冬氨酸受体脑炎发病机制中可能起重要作用，为抗N-甲基-D-天冬氨酸受体脑炎患者的降脂治疗提供了依据。
