| Objective: To analyze the clinical characteristics,prognosis and influencing factors of autoimmune encephalitis(AE)in order to provide reference for the formulation of clinical prevention and treatment.Methods: This study was a retrospective study.69 AE patients were selected from January 2016 to June 2018 in affiliated Hospital of Qingdao University and Xuanwu Hospital of Capital Medical University as the research objects.The gender,age,complications,pathogenesis,clinical manifestations,MRI,electroencephalogram,cerebrospinal fluid examination,related antibody examination,clinical treatment,prognosis after treatment and follow-up period were retrospectively analyzed.To summarize the main clinical characteristics of AE.According to the score of the improved MRS scale,69 patients were divided into good prognosis group(MRS score 0-3,51 cases)and poor prognosis group(MRS score 4-6,18 cases).The clinical data of the two groups were compared,and the single factor analysis was carried out to determine the single factor affecting the prognosis of AE.On this basis,logistic multivariate regression analysis was carried out to determine the uniqueness of the prognosis of AE.Establish influencing factors.Results:(1)Clinical manifestations: 75.36%(52 patients)had acute onset,17.39%(12 patients)had subacute onset,and only 7.25%(5 patients)had chronic disease.Among clinical manifestations,mental behavior abnormalities,cognitive disorders,and epilepsy are the main symptoms.(2)comorbid grade combined tumors: 84.06%(58 cases)of 69 patients had different underlying diseases,and many had multiple comorbidities at the same time.Among them,3(4.35%)had tumors.(3)Imaging and laboratory examinations: 81.16%(56 cases)of patients had abnormal MRI,;88.41%(61 cases)had mild to moderate EEG abnormal manifestations,the main characteristics were increased slow wave,,82.61%(23 cases)had focal or multifocal epileptiform discharges.(57 cases)had abnormal cerebrospinal fluid manifestations;all 69 patients had positive antibodies,Of these,50.72%(35 cases)were positive for anti-NMDAR antibody and 34.78%(24 cases)were positive for anti-leucine-rich glioma inactivation protein 1(LGI1)antibody,The anti-gamma-aminobutyric acid B receptor(GABABR)was positive for 11.60%(8 cases)and 2.90%(2 cases)anti-contact protein related protein 2(CASPR2)antibody was positive for 2 cases.(4)Characteristics of the disease: Among the 69 patients,38 males(55.07%)and 31females(44.93%),the proportion of males was slightly higher than that of females,however,the difference was not statistically significant(P>0.05).Among the 69 patients,the majority of patients <45 years old were significantly higher than those aged 45-60 years old and >60 years old.The difference was statistically significant(P<0.05).(5)Prognosis and influencing factors: 51 patients had a good prognosis after treatment and 6 months of follow-up,and 18 patients had a poor prognosis.Univariate analysis showed that malignant tumors,disturbance of consciousness,focal neurological symptoms,immunotherapy,and time from onset to immunotherapy were the single influencing factors.Logistic multivariate regression analysis confirmed that consciousness disorder,immunotherapy,and onset to immunotherapy were Independent influencing factors(P<0.05,OR in 95% CI range of OR),in which consciousness disorder,time from onset to immunotherapy was positively correlated with poor prognosis of AE,the higher the incidence of disturbance of consciousness,the longer the time from onset to immunotherapy The higher the risk of poor prognosis of patients,the negative correlation between immunotherapy and poor prognosis of AE.Active immunotherapy can prevent poor prognosis and reduce the incidence of poor prognosis.Conclusion: The clinical manifestations of AE are diverse,and there are many prodromal symptoms such as fever and headache.The initial symptoms are typical symptoms such as abnormal mental behavior,cognitive disorder and epilepsy.The disturbance of consciousness,immunotherapy,and the time from onset to immunotherapy are independent factors influencing the prognosis of AE. |
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