文章摘要
李娜,马联胜.不同脑电图分级标准在抗N-甲基-D-天门冬氨酸受体脑炎预后判断中的应用[J].安徽医药,待发表.
不同脑电图分级标准在抗N-甲基-D-天门冬氨酸受体脑炎预后判断中的应用
投稿时间:2022-12-04  录用日期:2023-01-23
DOI:
中文关键词: 抗NMDAR脑炎  脑电图  分级标准  预测预后  病情评估
英文关键词: 
基金项目:
作者单位地址
李娜 山西医科大学研究生学院 山西医科大学
马联胜* 山西医科大学附属第一医院神经内科 
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中文摘要:
      目的:探究4种临床常用的脑电图分级标准在抗N-甲基-D-天门冬氨酸受体( N-methyl-D-aspartic receptor,NMDAR)脑炎预后判断中的应用,选择预后预测价值最高的脑电图分级标准,研究此种分级标准在病情评估中的作用,及其与辅助检查及检验结果的相关性。方法:回顾性分析自2014年1月至2022年9月在我院诊断为抗NMDAR脑炎患者50例。根据ECBER、Synek 、Young 和Lavizzari分级标准,对患者入院后的首次脑电图进行分级。在患者出院时依据mRS评分评价预后,mRS评分0-2分为预后良好。比较4种不同脑电图分级标准与预后之间的相关性,选择预后预测效能最高的脑电图分级标准,研究其与病情严重程度、辅助检查及检验结果的相关性。结果:ECBER、Synek、 Lavizzari 3种脑电图分级标准与患者预后均有明显相关性(P <0.05),脑电图级别越高,预后越差。经预测效能分析,Lavizzari标准的预后预测效能最高(AUC值达到0.856,灵敏度为83.33%,特异度为76.32%, P<0.001)。Lavizzari标准分级越高,患者住院时间及监护室住院时间越长、症状数目及并发症越多、患者病情越严重(P<0.05),而与脑脊液抗体滴度及头颅MRI异常无关。结论:抗NMDAR脑炎患者脑电图异常比例较高,Lavizzari 脑电图分级标准对抗NMDAR脑炎患者早期病情评估及预后有较好预测价值,其异常程度与脑脊液抗体滴度、头颅MRI及疾病复发无关。
英文摘要:
      【Abstract】Objective: To explore the application of four commonly used clinical electroencephalograph (EEG) grading standards in the prognosis judgment of anti-NMDAR encephalitis, to select the electroencephalograph grading standards with the highest prognostic predictive value, and to study the role of such grading standard in the disease assessment and its correlation with auxiliary examination and test results. Methods: 50 patients diagnosed with anti-NMDAR encephalitis in our hospital from January 2014 to September 2022 were retrospectively analyzed. Patients were graded on the first EEG after admission according to four standards (ECBER, Synek, Young and Lavizzari). The prognosis of patients was evaluated according to mRS Score at discharge, and mRS Score 0-2 was defined as a good prognosis. The correlation between the four different EEG grading standard and prognosis was compared, and the EEG grading standard with the highest prognostic predictive efficacy was selected to study its correlation with the severity of disease, ancillary tests and test results. Results: The correlation between EEG standards and prognosis showed that the EEG standards of ECBER, Synek, and lavizzari had a positive correlation with prognosis (P < 0.05). The higher the EEG grade, the worse the prognosis. According to the predictive efficacy analysis, the Lavizzari standard grade had the highest prognostic predictive efficacy (AUC value of 0.856, sensitivity of 83.33%, specificity of 76.32%, P<0.001). The higher the Lavizzari standard grade, the longer the hospital and intensive care unit stay, the greater the number of symptoms and complications, and the more severe the patient's condition (P < 0.05), but not with cerebrospinal fluid antibody titers and cranial MRI abnormalities. Conclusion: The proportion of EEG abnormalities in patients with anti-NMDAR encephalitis was higher. The Lavizzari EEG grading standard has a good predictive value for the early disease assessment and prognosis of patients with anti-NMDAR encephalitis, and its abnormal degree is not related to cerebrospinal fluid antibody titer, head MRI and disease recurrence.
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