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中华脑科疾病与康复杂志(电子版) ›› 2022, Vol. 12 ›› Issue (02) : 81 -84. doi: 10.3877/cma.j.issn.2095-123X.2022.02.004

临床研究

重复应用静注人免疫球蛋白对抗NMDAR脑炎认知障碍的疗效观察
姚东陂1, 刘鹏1, 朱吉强1, 张建林1, 郑雪燕1, 孙千贺1, 史敏1, 王红欣2,()   
  1. 1. 100122 北京,北京朝阳中西医结合急诊抢救中心神经内二科
    2. 100122 北京,北京朝阳急诊抢救中心放射科
  • 收稿日期:2022-01-10 出版日期:2022-04-15
  • 通信作者: 王红欣

Observation on the efficacy of repeated intravenous administration of human immunoglobulin on cognitive impairment in patients with anti-NMDAR encephalitis

Dongpo Yao1, Peng Liu1, Jiqiang Zhu1, Jianlin Zhang1, Xueyan Zheng1, Qianhe Sun1, Min Shi1, Hongxin Wang2,()   

  1. 1. Department of Neurology, Beijing Chaoyang Integrative Medicine Emergency Medical Center, Beijing 100122, China
    2. Department of Radiology, Beijing Chaoyang Emergency Medical Center, Beijing 100122, China
  • Received:2022-01-10 Published:2022-04-15
  • Corresponding author: Hongxin Wang
引用本文:

姚东陂, 刘鹏, 朱吉强, 张建林, 郑雪燕, 孙千贺, 史敏, 王红欣. 重复应用静注人免疫球蛋白对抗NMDAR脑炎认知障碍的疗效观察[J/OL]. 中华脑科疾病与康复杂志(电子版), 2022, 12(02): 81-84.

Dongpo Yao, Peng Liu, Jiqiang Zhu, Jianlin Zhang, Xueyan Zheng, Qianhe Sun, Min Shi, Hongxin Wang. Observation on the efficacy of repeated intravenous administration of human immunoglobulin on cognitive impairment in patients with anti-NMDAR encephalitis[J/OL]. Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition), 2022, 12(02): 81-84.

目的

探讨重复应用静注人免疫球蛋白对抗N-甲基-D-天冬氨酸受体(NMDAR)脑炎患者认知障碍的疗效。

方法

收集北京朝阳中西医结合急诊抢救中心神经内科自2018年12月至2021年6月诊治的以认知障碍起病的抗NMDAR脑炎患者24例,采用随机数字表法分为对照组和研究组,每组12例。对照组给予注射用甲泼尼龙琥珀酸钠联合静注人免疫球蛋白基础治疗,研究组在相同基础治疗结束2周后,重复应用静注人免疫球蛋白。观察并比较2组患者治疗前后认知障碍改善情况及不良反应发生情况。

结果

研究组治疗后认知功能评分明显高于对照组,差异有统计学意义(P<0.05)。2组患者治疗期间均未出现严重不良反应,且所发生不良反应经对症治疗或治疗结束后均消失。2组患者的不良反应发生率比较,差异无统计学意义(P>0.05)。

结论

重复应用静注人免疫球蛋白能显著改善抗NMDAR脑炎患者的认知障碍,且相对安全。

Objective

To explore the efficacy of repeated intravenous administration of human immunoglobulin on cognitive impairment in patients with anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis.

Methods

A collection of 24 patients with anti-NMDAR encephalitis with cognitive impairment who were diagnosed and treated at the Neurology Department of Beijing Chaoyang Integrative Medicine Emergency Medical Center from December 2018 to June 2021, were randomly divided into control group and study group, with 12 cases in each group. The control group received injection methylprednisolone sodium succinate combined with intravenous human immunoglobulin basic therapy, and the study group received repeated intravenous injection of human immunoglobulin 2 weeks after the end of the same basic treatment. The improvement of cognitive impairment and the occurrence of adverse reactions were observed and compared between the two groups before and after treatment.

Results

The cognitive function score of the study group was significantly higher than that of the control group after treatment, and the difference was statistically significant (P<0.05). There were no serious adverse reactions during the treatment period in the two groups, and the adverse reactions occurred after symptomatic treatment or disappeared after treatment. There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05).

Conclusion

Repeated application of intravenous human immunoglobulin can significantly improve cognitive impairment in patients with anti-NMDAR encephalitis, and it is relatively safe.

表1 2组患者治疗前后MMSE评分比较(分,Mean±SD)
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