抗N-甲基-D-天门冬氨酸受体脑炎合并卵巢畸胎瘤的研究进展

Research Advances in Anti-N-methyl-D-aspartate Receptor Encephalitis Associated with Ovarian Teratoma

抗N-甲基-D-天门冬氨酸受体脑炎是近年新发现的一种自身免疫性疾病,多合并畸胎瘤等生殖细胞肿瘤,发病机制可能为抗N-甲基-D-天门冬氨酸受体抗体干扰神经信号传递所致,目前尚未完全清楚。该病临床表现呈多样性,主要分为行为认知异常、记忆障碍、语言障碍、运动障碍、自主神经功能障碍、癫痫发作、意识丧失及低通气8组症状,可呈单一表现,也可联合几组症状同时表现,其临床症状主要由抗N-甲基-D-天门冬氨酸受体抗体累及的脑部解剖结构所决定。治疗以免疫治疗合并肿瘤切除为主,预后较好。综述抗N-甲基-D-天门冬氨酸受体脑炎合并卵巢畸胎瘤的相关研究,以期提高临床医生对该病的认识。

Anti-N-methyl-D-aspartate receptor（anti-NMDAR） encephalitis, always associated with germ cell tumors such as teratoma, is an autoimmune disorder, which was discovered recently. The pathogenesis is very likely related to anti-NMDAR antibody, which may obstruct the transmission of neural signals, however, the mechanism that the antibody works has not been revealed entirely. Clinical manifestation of this disease is diverse and doctors categorized symptoms into eight groups：behavior and cognitive disorder, memory disorder, language barrier, movement disorder, autonomic dysfunction, seizure, loss of consciousness and hypopnea. These groups of symptoms can be a single performance, and also can be combined with several groups, and the clinical manifestations are mainly determined by anti-NMDAR antibody involving which part of the brain. The treatment combines immunotherapy with tumor resection and the prognosis is good. This review mainly introduces the researches on anti-NMDAR encephalitis associated with ovarian teratoma to improve the awareness of clinicians on this disease.