神经外科免疫相关疾病

Immune-related diseases in neurosurgery

某些原发性或继发性中枢神经系统疾病与人体免疫功能密切相关:系统性自身免疫性疾病如多发性大动脉炎可造成颅内血管病变,自身免疫系统功能紊乱可造成边缘性脑炎、自身免疫性垂体炎等,免疫系统功能缺陷患者易罹患神经系统机会性感染和恶性淋巴瘤等。但很多神经外科免疫相关疾病发病机制尚不明确,缺乏诊断"金标准",部分神经外科免疫相关疾病如人类免疫缺陷病毒脑病、神经系统副肿瘤综合征等存在发病率低、临床误诊率高等特点。本文通过对相对常见的神经外科免疫相关疾病病理生理学、临床和影像学表现、治疗进行简要阐述,以期提高临床医师对此类疾病的认识。

Some primary or secondary diseases of the central nervous system are closely related to human immune system.Autoimmune diseases such as multiple Takayasu arteritis(MTA)can cause intracranial vascular lesions.The disorder of autoimmune system can cause limbic encephalitis(LE)and autoimmune hypophysitis(AH).Patients with immunodeficiency disease are prone to opportunistic infections of the nervous system and malignant lymphoma.At present,the pathogenesis of many immunerelated diseases in neurosurgery are not clear,and there is a lack of"golden standard"for diagnosis.Some immune-related diseases in neurosurgery,such as human immunodeficiency virus(HIV)encephalopathy and paraneoplastic neurological syndrome(PNS),have low incidence and high clinical misdiagnosis rate.Most of the immune-related diseases in neurosurgery have their own characteristics in terms of pathophysiology,clinical and imaging feature,etc.Understanding these characteristics will be of great help to the diagnosis and differential diagnosis of relevant clinical diseases.This paper intends to briefly describe the common immune-related diseases in neurosurgery,so as to improve clinicians’understanding of immune-related diseases in neurosurgery and even save more patients’lives.