Psychiatric Symptoms of Patients With Anti-NMDA Receptor Encephalitis
Psychiatric Symptoms of Patients With Anti-NMDA Receptor Encephalitis
复制标题
抗NMDA受体脑炎患者的精神症状
DOI：
10.3389/fneur.2019.01330
复制
发表时间：
2020-01-24
影响因子：
3.4
通讯作者：
Li, Jin-Mei
中科院分区：
文献类型：
--
作者：
Wang, Wei;Zhang, Le;Li, Jin-Mei
目的：分析抗NMDAR脑炎患者精神症状的临床特点。方法：对我国抗NMDAR脑炎的流行病学资料进行回顾性分析。分析抗NMDAR脑炎患者精神症状的临床特征、抗NMDAR抗体滴度与临床特征的关系。结果：共有108例确诊为抗NMDAR脑炎的患者纳入本研究。103名患者（95%）出现一种或多种精神症状。高滴度组与低滴度组比较，高滴度组以精神症状为首发症状的患者多于低滴度组（P = 0.020），抑郁、紧张、中枢性通气不足等症状的发生率高滴度组也高于低滴度组（P分别为0.033、0.031和0.006）。同时，高滴度组接受IVIg和糖皮质激素联合治疗的患者多于低滴度组，高滴度组使用抗精神病药物的患者多于低滴度组（P值分别为0.026和0.003）。结论：精神症状是抗NMDAR脑炎患者最常见的临床特征。抗体滴度高的患者更常以精神症状为首发症状，并表现出更严重的临床特征。抗NMDAR抗体的筛查对于出现精神症状伴或不伴其他神经系统症状的患者至关重要。
Objective: We conducted this study to analyze the clinical characteristics of the psychiatric symptoms of patients with anti-NMDAR encephalitis. Methods: A retrospective study of anti-NMDAR encephalitis in China was performed. The clinical characteristics of the psychiatric symptoms, the relationship between the antibodies titers and clinical characteristics of patients with anti-NMDAR encephalitis were determined. Results: A total of 108 patients with a definitive diagnosis of anti-NMDAR encephalitis were included in this study. 103 patients (95%) developed one or several psychiatric symptoms. The comparison of the high titer group and the low titer group showed that more patients presented psychiatric symptoms as the initial symptom in the high titer group (P = 0.020), the prevalence of the symptoms such as depressive, catatonic, and central hypoventilation were also higher in the high titer group than the low titer group (P = 0.033, 0.031 and 0.006, respectively). Meanwhile, more patients received a combination treatment of IVIg and corticosteroids in the high titer group than the low titer group and patients in high titer group were prescript with anti-psychiatric drugs more often than the patients in low titer group (P = 0.026 and 0.003, respectively). Conclusions: Psychiatric symptoms are the most common clinical characteristics of patients with anti-NMDAR encephalitis. Patients with higher antibodies titers more often presented with psychiatric symptoms as the initial symptom, and showed a more severe clinical feature. Screening for the anti-NMDAR antibodies is essentially important in patients who present psychiatric symptoms with or without other neurological symptoms.