抗N-甲基-D-天冬氨酸受体脑炎的抗体检测及临床意义

Clinical significance of anti-N-methyl-D-aspartate receptor antibody detection in patients with encephalitis

摘要:

目的 探讨抗N-甲基-D-天冬氨酸受体(NMDAR)脑炎的抗体检测意义及临床特征.方法 选取本院收治的脑炎病人35例及对照组30例,分析临床资料,采用转染细胞间接免疫荧光法检测两组患者其血清及脑脊液抗NMDAR抗体.结果 抗NMDAR抗体检测仅1例边缘叶脑炎患者结果阳性,该患者脑脊液细胞数增多、蛋白轻度升高、脑电图见双侧慢波、其余检查无异常.精神症状及意识水平障碍明显,免疫治疗有效.结论 抗NMDAR脑炎发病率低,临床表现复杂多样,怀疑该病时需行抗NMDAR抗体检测.

Abstract:

Objective To investigate the clinical features of anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis and the significance of anti-NMDAR antibody detection.Methods Thirty-five patients with encephalitis and 30 controls were selected in our hospital. Their clinical data were analyzed. Transfected cell-based indirect immunofluorescence assay was used to detect anti-NMDAR antibodies in serum and cerebrospinal fluid.Results Anti-NMDAR antibodies were detected in one patient with limbic encephalitis. This patient had an increased number of cells and mildly elevated protein levels in the cerebrospinal fluid, as well as bilateral slow waves on EEG; there were obvious disorders in psychiatric symptoms and level of consciousness; the patient was responsive to early immunotherapy.Conclusions Anti-NMDAR encephalitis has low incidence and various clinical manifestations, and detection of anti-NMDAR antibodies may be needed for suspected cases.