抗γ-氨基丁酸B型受体脑炎的临床特点及预后分析
Clinical Characteristics and Prognosis of Anti-γ-Aminobutyric Acid B Receptor Encephalitis
DOI: 10.12677/ACM.2024.142555, PDF,   
作者: 刘益梅, 王 雁*：青岛大学附属医院神经内科，山东 青岛
关键词: 受体；GABA-B；预后；抗体滴度；Receptor； GABA-B； Prognosis； Antibody Titer
摘要: 目的：分析抗γ-氨基丁酸B型受体(GABABR)受体脑炎患者临床特点及预后的相关因素。方法：收集2017年1月至2022年12月于山东3所医院确诊为抗γ-氨基丁酸B型受体脑炎的31例患者的临床资料并进行回顾性分析。并对患者的死亡风险、预后不良(mRS)风险进行评估。结果：31例抗GABABR抗体脑炎患者中，男性22例(71%)，女性9例(29%)，中位年龄64 (范围22~78)岁。其中死亡14例(45.2%)，预后不良(mRS > 2分) 16例(51.6%)。单因素分析示，肿瘤、发热、血清高抗体滴度、脑脊液高抗体滴度与预后不良显著相关(P < 0.05)。多因素Logistic回归分析示肿瘤是抗GABABR脑炎死亡的独立危险因素。抗体滴度与初次发病的严重程度及短期预后无关，与长期预后相关，并且在血清中具有更高的显著性(P = 0.002)。结论：抗GABABR脑炎死亡率高，约半数合并肿瘤并死于肿瘤进展，发病时应及时完善肿瘤筛查。抗体滴度与患者的长期预后相关，血清抗体滴度高的患者更易出现不良预后。
Abstract: Objective: To analyze the clinical characteristics and related factors of prognosis in patients with anti-γ-aminobutyric acid B receptor (GABABR) encephalitis. Methods: Retrospective analysis of 31 patients diagnosed with anti-GABABR encephalitis in three hospitals in Shandong province from January 2017 to December 2022 was carried out, with assessment of factors associated with mor-tality and adverse prognosis (mRS > 2). Results: A total of 31 patients with anti-GABABR encephali-tis were included in this study, with 22 males (71%) and 9 females (29%). The median age was 64 years (range 22~78). Among them, 14 cases (45.2%) died and 16 cases (51.6%) had poor prognosis (mRS > 2). Univariate analysis showed that tumors, fever, high serum antibody titers, and high cerebrospinal fluid (CSF) antibody titers were significantly associated with poor prognosis (P < 0.05). Multivariate logistic regression analysis showed that tumors were independent risk factors for mortality in anti-GABABR encephalitis. Antibody titers were not related to the severity of the in-itial onset and short-term prognosis, but were related to long-term prognosis, with higher signifi-cance in serum (P = 0.002). Conclusion: The mortality rate of anti-GABABR encephalitis is high, with approximately half of the cases associated with tumors and dying from tumor progression. Timely tumor screening should be performed at the time of onset. Antibody titers are related to the long-term prognosis of the patients, and patients with high serum antibody titers are more likely to have a poor prognosis.
文章引用：刘益梅, 王雁. 抗γ-氨基丁酸B型受体脑炎的临床特点及预后分析[J]. 临床医学进展, 2024, 14(2): 3996-4003. https://doi.org/10.12677/ACM.2024.142555

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