标题：自主神经症状、免疫治疗与自身免疫性脑炎患者预后的关联性

      作者：周勇，胡冰凌    巴中市中心医院神经内科，四川 巴中 636000

      卷次： 2019年30卷16期

      【摘要】 目的 探讨自主神经症状、免疫治疗与自身免疫性脑炎(AE)患者预后的关联性。方法 回顾性分析巴中市中心医院神经内科2017年3月至2018年11月收治的56例AE患者的临床诊治资料，比较预后良好组和预后不良组患者的基线资料，并采用Logistic回归分析方法分析影响AE预后的相关因素。结果 预后良好组和预后不良组患者的自主神经症状(20.0% vs 12.5%)、意识障碍(52.5% vs 93.75%)、局灶性神经症状及体征(20.0% vs 62.50%)、发热(42.5% vs 75.00%)、免疫治疗(90.0% vs 62.50%)、抗体种类(22.5% vs 31.25%)比较，差异均有统计学意义(P<0.05)，而两组患者在合并肿瘤、癫痫发作、认知障碍、精神行为异常、头痛、急性起病方面比较差异均无统计学意义(P>0.05)；经Logistic回归分析结果显示，免疫治疗为AE预后的重要保护因素(P<0.05)，而自主神经症状为AE预后的重要危险因素(P<0.05)。结论 AE患者经免疫治疗或肿瘤相关治疗等对应干预后通常可取得良好预后效果，且免疫治疗为AE预后重要保护因素、自主神经症状为AE预后重要危险因素，临床上可针对存在自主神经症状者早期给予免疫治疗。
      【关键词】 自主神经症状；免疫治疗；自身免疫性脑炎；预后；关联性
      【中图分类号】 R512.3 【文献标识码】 A 【文章编号】 1003—6350（2019）16—2048—04

Correlation between autonomic symptoms, immunotherapy and prognosis of patients with autoimmuneencephalitis.
ZHOU Yong, HU Bing-ling. Department of Neurology, Bazhong Central Hospital, Bazhong 636000, Sichuan,CHINA
【Abstract】 Objective To explore the correlation between autonomic symptoms, immunotherapy and prognosisin patients with autoimmune encephalitis (AE). Methods The clinical data of 56 patients with AE admitted to the De-partment of Neurology, Bazhong Central Hospital from March 2017 to November 2018 were retrospectively analyzed.The baseline data of the two groups were compared and the related factors affecting the prognosis of AE were analyzedby logistic regression analysis. Results There were significant differences in autonomic neurological symptoms (20.0%vs 12.5%), consciousness disorders (52.5% vs 93.75%), focal neurological symptoms and signs (20.0% vs 62.50%), fever(42.5% vs 75.00%), immunotherapy (90.0% vs 62.50), and antibody types (22.5% vs 31.25%) between the good progno-sis group and the poor prognosis group (P<0.05). There was no significant difference in epilepsy, cognitive impairment,mental and behavioral disorders, headache and acute onset (P>0.05). Logistic regression analysis showed that immuno-therapy was an important protective factor for AE prognosis (P<0.05), while autonomic neurological symptoms were animportant risk factor for AE prognosis (P<0.05). Conclusion Patients with AE usually have good prognosis after corre-sponding interventions such as immunotherapy or cancer-related therapy. Immunotherapy is an important protective fac-tor for AE prognosis and autonomic neurosis is an important risk factor for AE prognosis. Early immunotherapy is rec-ommended for patients with autonomic neurosis symptoms in clinical practice.
      【Key words】 Autonomic neurological symptoms; Immunotherapy; Autoimmune encephalitis; Prognosis; Correlationdoi:10.3969/j.issn.1003-6350.2019.16.003