卵巢畸胎瘤相关抗N-甲基-D-天冬氨酸受体脑炎9例临床分析

摘要

目的 探讨抗N-甲基-D-天冬氨酸受体(NMDAR)脑炎的临床特征及诊治策略.方法 收集2013年12月至2015年12月首都医科大学宣武医院收治的抗NMDAR脑炎9例女性患者,总结该病的临床特点、诊断方法及治疗策略,并结合文献进行分析讨论.结果 抗NMDAR脑炎患者多起病于精神异常或抽搐,临床表现多样,如意识减退、运动障碍、自主神经异常、低通气等.头颅影像学检查,如CT或MRI及脑电图无特异性,脑脊液抗NMDAR抗体阳性为诊断的关键.及时诊治,预后较好.结论 抗NMDAR脑炎临床表现以神经及精神异常为主,易误诊而延误治疗.神经、精神科和妇科医生要充分认知该疾病,做到早期诊断,及时给予手术干预,从而改善患者的预后.%Objective To summarize the clinical features、diagnostic criteria and treatment of Anti-NMDAR encephalitis.Methods Totally 9 cases with anti-NMDAR encephalitis in the Xuanwu hospital of capital medical university,and ovarian tumors was found in 6 of these cases.We analyzed the clinical manifestations,laboratory tests,treatment and prognosis of this disease.Results The disease was characterized by significant psychiatric symptoms、memory loss、epilepsy、movement disorders and decrease consciousness.And some patients required assisted ventilation.Diagnosis depends on detecting anti-NMDAR antibodies.Gynecologists played important roles in treating with this disease.All patients had good prognosis.Conclusion When patients are diagnosed and found ovarian teratoma at early stages,and surgical removal of ovarian teratoma,the clinical outcome will be improved.