儿童抗N-甲基-D-天门冬氨酸受体脑炎近期预后危险因素分析

Risk factors for the short-term prognosis of anti-N-methyl-D-aspartic acid receptor encephalitis in children

目的观察抗N-甲基-D-天门冬氨酸受体(抗NMDAR)脑炎近期预后的危险因素。方法回顾性分析66抗NMDAR脑炎患儿的临床资料和治疗前后的改良Rankin量表(mRS)评分。根据治疗结果将患儿mRS≤2分的设为试验组,评分mRS≥3分的设为对照组。并对预后不良的危险因素进行单因素和多因素Logistic回归分析。结果在66例患儿中,39例预后良好,27例预后不良。单因素分析结果显示,年龄、住院天数、癫痫、运动障碍、治疗前mRS评分和预后不良有相关性。多因素Logistic回归分析显示,年龄、癫痫发作、治疗前mRS评分为抗NMDAR脑炎近期预后不良的独立危险因素。结论抗NMDAR脑炎患者发病年龄小、有癫痫发作、治疗前评分高可能预示近期预后不良。

Objective To observe the risk factors of the short-term prognosis of anti-N-methyl-D-aspartic acid（ anti-NMDAR）encephalitis. Methods The clinical data of 66 children with anti-NMDAR encephalitis was analyzed retrospectively, and the scores of modified Rankin scale（ mRS） were used before and after treatment.According to the treatment results,the children with mRS less than or equal to 2 points were used as treatment group,those with mRS score more than 3 points were set as the control group. Single factor and multiple factor Logistic regression analysis were used to analyze the risk factors of poor prognosis. Results Of the 66 cases,39 had good prognosis and27 had poor prognosis. The results of single factor analysis showed that age,days of hospitalization,epilepsy,dyskinesia,mRS scores score were associated with poor prognosis. Multiple factor Logistic regression analysis showed that age,epileptic seizures,and mRS scores before treatment were independent risk factors for the short-term prognosis of anti-NMDAR encephalitis. Conclusion Patients with anti-NMDAR encephalitis have small age, seizures and high mRS scores before treatment,which may predict poor prognosis in the near future.