自身免疫性脑炎49例的预后分析

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Abstract Objective To analyze the features of clinical symptoms, neurological functional recovery and the prognostic factors of autoimmune encephalitis. Methods A retrospective study of 49 patients diagnosed with autoimmune encephalitis in the First Affiliated Hospital of Chongqing Medical University from January 2013 to February 2017 was performed. Clinical data were collected and followed up. The neurological functional recovery was evaluated through modified ranking scale (mRS). The patients were divided into the recovery group (mRS score 0-1, 32 cases), partial recovery group (mRS score 2-3 scores, 7 cases), and poor prognosis group (mRS score > 3 scores, 10 cases), and the prognostic factors were analyzed using statistical methods of Logistic regression analysis of ordered categorization. Results 79.59％ patients were completely recovered or remained mild neurological dysfunction. 75.61％ of the mental and behavior disorders were fully recovered, 94.29% of the seizures were controlled, 69.57％ of the recent memory disorders were completely recovered, 87.50％ of the inadvertent movement were controlled, 90.63％ of the central nervous system focal damage were fully recovered and 16.33％ of the patients relapsed. Comparison of clinical data of initial onset among the three groups showed that people in abnormal immune status before onset and initial clinical manifestation with autonomic dysfunction or central hypoventilation had statistically significant difference(P < 0.05). Abnormal immune status before the disease and the first onset accompanied by autonomic nervous dysfunction or central hypoventilation are independent predictors of poor prognosis in patients with autoimmune encephalitis (P < 0.05). Conclusion The majority of autoimmune encephalitis patients have favorable prognosis, but some of the patients may remain various degrees of neurological deficiency, including mental and behavior disorders and recent memory disorders. People in abnormal immune status before the onset and initial clinical manifestation with autonomic dysfunction or central hypoventilation may indicate a poorer prognosis． Immunotherapy can improve outcomes.

Key words： Autoimmune encephalitis Clinical features Prognosis

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	GUO Tongli1 LI Guangqin1 SUN Jinhui2 LUO Yetao3

Cite this article:

GUO Tongli1 LI Guangqin1 SUN Jinhui2 LUO Yetao3. Prognosis analysis of 49 cases with autoimmune encephalitis[J]. 中国医药导报, 2018, 15(23): 62-66.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2018/V15/I23/62

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