本文選題：自身免疫性腦炎 + 預(yù)后�。� 參考：《吉林大學(xué)》2017年碩士論文

【摘要】：自身免疫性腦炎臨床表現(xiàn)多樣,伴或不伴腫瘤,腦脊液、影像學(xué)及血清學(xué)檢查無明顯特異性,極易誤診。該病主要根據(jù)腦脊液和(或)血清中檢測到相關(guān)抗體而確診,而相關(guān)抗體檢測結(jié)果需較長時間,因此延誤診斷,不利于治療。據(jù)此自身免疫性腦炎的國際臨床診斷標準和排除標準已被提出。國外學(xué)者提出早期免疫治療及避免進入重癥監(jiān)護室是抗NMDAR腦炎預(yù)后良好的因素,通過相關(guān)文獻復(fù)習(xí),目前國內(nèi)尚無學(xué)者對影響自身免疫性腦炎預(yù)后的相關(guān)因素進行大數(shù)據(jù)統(tǒng)計回顧分析,本課題就自身免疫性腦炎預(yù)后的相關(guān)因素進行分析及評估,以提高對AE及其預(yù)后的認識,并為其及時診治及改善預(yù)后提供依據(jù)。目的:研究自身免疫性腦炎預(yù)后的相關(guān)因素,并對其進行分析及評估,以提高AE及其預(yù)后的認識,為其及時診治及改善預(yù)后提供參考依據(jù)。方法:回顧性分析52例AE患者的臨床資料,比較預(yù)后良好組與預(yù)后不良組患者之間的各項臨床資料特征,利用SPSS23.0軟件進行統(tǒng)計數(shù)據(jù)分析,探討影響自身免疫性腦炎預(yù)后的相關(guān)因素。結(jié)果:單因素分析得出:伴基礎(chǔ)疾病、發(fā)熱、神經(jīng)局灶癥狀及體征、意識障礙、通氣障礙、心率及血壓異常等自主神經(jīng)癥狀、免疫治療、抗AMPA受體抗體在預(yù)后良好組和預(yù)后不良組之間有統(tǒng)計學(xué)差異;經(jīng)多變量Logistic回歸分析,篩選出意識障礙、免疫治療是影響自身免疫性腦炎預(yù)后的獨立危險因素。結(jié)論:(1)意識障礙和免疫治療是影響自身免疫性腦炎預(yù)后的獨立因素。(2)存在意識障礙的患者預(yù)后不良,早期給予免疫治療可改善預(yù)后。
[Abstract]:The clinical manifestations of autoimmune encephalitis are various, with or without tumor, cerebrospinal fluid, imaging and serological examination without obvious specificity, so it is easy to be misdiagnosed. The diagnosis of the disease is mainly based on the detection of related antibodies in cerebrospinal fluid and / or serum, but the results of detection of related antibodies take a long time, so the diagnosis is delayed and is not conducive to treatment. Accordingly, the international diagnostic criteria and exclusion criteria for autoimmune encephalitis have been proposed. Foreign scholars put forward that early immunotherapy and avoiding entry into intensive care unit are good prognostic factors of NMDAR encephalitis. At present, there are no scholars in China to make a retrospective big data statistical analysis of the related factors affecting the prognosis of autoimmune encephalitis. In order to improve the understanding of AE and its prognosis, this paper analyzes and evaluates the factors related to the prognosis of autoimmune encephalitis. And to provide basis for timely diagnosis and treatment and improve prognosis. Objective: to study the prognostic factors of autoimmune encephalitis, and to analyze and evaluate them so as to improve the understanding of AE and its prognosis, and to provide reference for timely diagnosis and treatment of autoimmune encephalitis. Methods: the clinical data of 52 patients with AE were analyzed retrospectively. The clinical data were compared between the patients with good prognosis and those with poor prognosis. The statistical data were analyzed by SPSS 23.0 software. Objective: to investigate the prognostic factors of autoimmune encephalitis. Results: univariate analysis showed that autonomic nervous symptoms, such as basic diseases, fever, neurological focal symptoms and signs, disturbance of consciousness, disturbance of ventilation, abnormal heart rate and blood pressure, were associated with immunotherapy. The anti-AMPA receptor antibody had statistical difference between the group with good prognosis and the group with poor prognosis, and was screened out by multivariate logistic regression analysis, and immunotherapy was an independent risk factor affecting the prognosis of autoimmune encephalitis. Conclusion (1) consciousness disorder and immunotherapy are independent factors influencing the prognosis of autoimmune encephalitis. The prognosis of patients with consciousness disorder is poor. Early immunotherapy can improve the prognosis of patients with autoimmune encephalitis.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R742.9

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