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卵巢畸胎瘤相关性抗N-甲基-D-天冬氨酸受体脑炎: 7例报告并文献复习

王观凤 张赛男 郑丽娇 彭冬先

王观凤, 张赛男, 郑丽娇, 彭冬先. 卵巢畸胎瘤相关性抗N-甲基-D-天冬氨酸受体脑炎: 7例报告并文献复习[J]. 分子影像学杂志, 2019, 42(2): 267-270. doi: 10.12122/j.issn.1674-4500.2019.02.29
引用本文: 王观凤, 张赛男, 郑丽娇, 彭冬先. 卵巢畸胎瘤相关性抗N-甲基-D-天冬氨酸受体脑炎: 7例报告并文献复习[J]. 分子影像学杂志, 2019, 42(2): 267-270. doi: 10.12122/j.issn.1674-4500.2019.02.29
Guanfeng WANG, Sainan ZHANG, Lijiao ZHENG, Dongxian PENG. Clinical analysis of 7 cases of ovarian teratoma complicated with anti-N-methyl-D-aspartate receptor encephalitis[J]. Journal of Molecular Imaging, 2019, 42(2): 267-270. doi: 10.12122/j.issn.1674-4500.2019.02.29
Citation: Guanfeng WANG, Sainan ZHANG, Lijiao ZHENG, Dongxian PENG. Clinical analysis of 7 cases of ovarian teratoma complicated with anti-N-methyl-D-aspartate receptor encephalitis[J]. Journal of Molecular Imaging, 2019, 42(2): 267-270. doi: 10.12122/j.issn.1674-4500.2019.02.29

卵巢畸胎瘤相关性抗N-甲基-D-天冬氨酸受体脑炎: 7例报告并文献复习

doi: 10.12122/j.issn.1674-4500.2019.02.29
详细信息
    作者简介:

    王观凤,硕士研究生,E-mail:18820791569@163.com

    通讯作者:

    彭冬先,副主任医师,硕士生导师,E-mail:pengdx1969@163.com

Clinical analysis of 7 cases of ovarian teratoma complicated with anti-N-methyl-D-aspartate receptor encephalitis

  • 摘要: 目的探讨卵巢畸胎瘤相关性抗N-甲基-D-天冬氨酸受体(NMDAR)脑炎的临床特征、治疗方法及预后。方法回顾性分析南方医科大学珠江医院2014年7月~2017年12月收治的7例抗NMDAR脑炎合并卵巢畸胎瘤患者的临床资料结果本报道7例患者病程中均表现有异常精神行为,其中2例患者以此为首发症状,3例患者因中枢性低通气,予气管切开机械辅助通气,1例患者仅表现为精神行为异常及前驱症状。7例患者行脑脊液特异性检测均可见抗NMDAR抗体阳性,血清学检测抗NMDAR抗体结果为6例阳性,1例阴性。7例患者病情进展不完全一致,但均在手术切除卵巢畸胎瘤后病情好转。随访至今(半年~3年),7例患者现一般情况可,精神行为基本正常,未见脑炎及卵巢畸胎瘤复发。结论抗NMDAR脑炎是一种新的边缘叶副肿瘤性脑炎,目前大部分研究提示其与卵巢畸胎瘤密切相关,合并有卵巢畸胎瘤的抗NMDAR脑炎在手术切除卵巢畸胎瘤后病情好转快,大部分患者预后良好。

     

  • 表  1  7例卵巢畸胎瘤相关性抗NMDAR抗体脑炎患者的临床资料

    病例 性别 年龄 前驱
    症状
    精神
    症状
    意识
    障碍
    癫痫
    发作
    自主神经
    功能障碍
    不自主
    运动
    血清/脑脊液
    NMDA抗体
    脑电图 头颅
    MR/CT
    卵巢畸
    胎瘤
    肿瘤内
    神经成分
    1 25 - + + 首发 + + + -/+ + + + -
    2 28 + 首发 + + + + + +/+ + - + -未成熟型,II型
    3 17 - + + + 首发 + + +/+ + - + +
    4 30 + 首发 + - - - - +/+ + + + +
    5 30 + + + + 首发 + + +/+ + + + +
    6 23 + + 首发 + + + + +/+ + + + +
    7 29 + + 首发 + + + + +/+ + + + +
    下载: 导出CSV
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  • 收稿日期:  2019-01-12
  • 刊出日期:  2019-04-01

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