在成人台湾患者中验证自身免疫性脑炎的预测工具:一项回顾性研究
Yan-Ting Lu1, Chih-Hsiang Lin1, Chen-Jui Ho1
1Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung 833401, Taiwan.
Biomedicines
|July 29, 2023
概括
在台湾,自身免疫性脑炎 (AE) 的预测工具的有效性各不相同. 与APE和RITE分数相比,NEOS分数显示AE患者的长期预测价值更好.
科学领域:
- 神经学 神经学
- 免疫学 免疫学 免疫学
- 临床预测模型临床预测模型
背景情况:
- 自身免疫性脑炎 (AE) 是一种关键的神经疾病,需要及时诊断和管理.
- 预测工具对于评估AE患者的结果和指导治疗策略至关重要.
研究的目的:
- 评估台湾人口中自身免疫性脑炎现有评分系统的临床效用和预测准确性.
- 为了比较抗体发病率在 (APE),响应免疫疗法在 (RITE),和抗NMDAR脑炎的一年功能状态 (NEOS) 评分的性能.
主要方法:
- 在2008年1月至2019年12月期间接受治疗的27名自身免疫脑炎患者的回顾性分析.
- 应用APE,RITE和NEOS得分,计算灵敏度,特异性和曲线下的面积 (AUC),使用接收器操作特征 (ROC) 分析.
主要成果:
- 在中抗体患病率 (APE) 得分的AUC为0.571,而在中对免疫治疗的反应 (RITE) 得分的AUC为0.550.
- 抗NMDAR脑炎一年功能状态 (NEOS) 评分显示AUC值在出院时为0.645和长期随访时为0.796.
- APE和RITE得分表现不佳,可能是由于样本规模小和单一的种族,而NEOS显示出更好的长期预测能力.
结论:
- 抗体发病率在 (APE) 和响应免疫疗法在 (RITE) 的得分显示在研究的台湾队列中适用性有限.
- 抗NMDAR脑炎一年功能状态 (NEOS) 评分显示,它有望预测自身免疫脑炎患者的长期结果,特别是在后期的随访阶段.
相关概念视频
01:19Encephalitis l: Introduction
Encephalitis is inflammation of the brain parenchyma, most often due to infections or autoimmune processes. It presents with neuropsychiatric features such as fever, altered mental status, behavioral changes, cognitive dysfunction, seizures, focal deficits, and sometimes autonomic instability. In some cases, the meninges are also involved, resulting in meningoencephalitis.Infectious CausesInfectious encephalitis is most commonly viral but can also result from bacterial, fungal, or parasitic...
01:26Encephalitis ll: Pathophysiology
Encephalitis is inflammation of the brain parenchyma caused by direct viral invasion or immune-mediated mechanisms triggered by infections or tumors. Both processes lead to neuronal injury, disrupted neurotransmission, and diverse neurological symptoms, often with overlapping clinical and pathological features.Autoimmune EncephalitisIn autoimmune encephalitis, antibodies target neuronal antigens on cell surfaces, synapses, or within neurons. A key example is anti-NMDAR encephalitis, which can...