| Objective:The clinical manifestations of autoimmune encephalitis(AE)are diverse,and there is no obvious specificity in general laboratory and imaging examination,and the diagnosis is highly dependent on antibody positive test.Most patients can fully recover after receiving immunotherapy and/or tumor resection,part of the legacy of sequelae and a small number of deaths.Early immunotherapy and avoidance of icu are favorable prognostic factors,and the presence of disturbance of consciousness,status epilepticus and autonomic nervous dysfunction during the course of the disease may indicate poor prognosis.At present,the influencing factors of long-term prognosis of autoimmune encephalitis have not been determined.The purpose of this study was to investigate the prognostic factors of children with autoimmune encephalitis by analyzing the clinical data.Methods: Selection in August 2016 to December 2018 were analyzed in handan city first hospital pediatric neurology group of 44 cases of confirmed or examination for children with AE to collect the patient’s demographic,clinical manifestation,laboratory examination,cerebrospinal fluid IL-6,CXCL10,CXCL13,imaging and other clinical data and follow-up,analysis of children with acute phase and the changes of cytokines in cerebrospinal fluid in the remission;Through improved Ranking scale(mRS)to assess children with nerve functional recovery,and divided into good prognosis group(mRS score 2 points or less)and poor prognosis group(mRS score 3 points or higher),compare the characteristics between the two groups of children with clinical data,IBM SPSS V20.0 software was used to statistical analysis,to explore the related factors influencing the prognosis of children autoimmune encephalitis.Results:1.The levels of IL-6,CXCL13 and CXCL10 in the cerebrospinal fluid of the children with anti-NMDAR encephalitis and antibody-negative AE in the acute phase were significantly higher than those in the remission phase,with a significant difference;2.The levels of IL-6,CXCL13 and CXCL10 in the cerebrospinal fluid of children with anti-LGI1 encephalitis in the acute phase showed no significant changes as compared with those in the remission phase;3.Univariate analysis: age,headache,disturbance of consciousness,dysplasia of limbs,cognitive impairment,mRS score atthe time of the most serious illness,difference of CXCL13 between the acute stage and the remission stage of PICU and cerebrospinal fluid(except anti-LGI1encephalitis)had statistical significance between the good prognosis group and the bad prognosis group;4.Multivariate analysis: consciousness disorder,limb movement disorder and mRS score at the most severe stage were independent risk factors affecting the prognosis of AE.Conclusions:The levels of IL-6,CXCL10 and CXCL13 in the cerebrospinal fluid of children with anti-NMDAR encephalitis and antibody-negative AE in the acute phase were significantly higher than those in the remission phase,which may be related to the severity of the disease,but has no correlation with the prognosis,which still needs to be studied with a large sample;Most AE patients had a good prognosis after active immunotherapy;Consciousness disturbance,limb movement disturbance and mRS score were independent risk factors for AE prognosis. |
