CAJ | 학술논문

目的探讨血浆置换(PE)治疗抗N-甲基-M-天冬氨酸(NMDA)受体脑炎的安全性和可操作性.方法前瞻性观察研究2012年1月至2015年1月收入宣武医院神经内科监护病房的抗NMDA受体脑炎患者PE治疗的不良反应和疗效.结果共纳入9例患者接受PE治疗54次,全部(100％)患者经过PE治疗后CSF和(或)血清中NMDA受体抗体滴度均有减低或转为阴性,共5例(55.5％)患者临床好转.PE不良反应依次为:不自主运动增加、低血压、PE管路凝血、体温升高、过敏反应和深静脉置管处管口周围渗血.无致死的严重不良反应.结论 PE可有效治疗抗NMDA受体脑炎,并且安全可行.
목적 탐토혈장치환(PE)치료항N-갑기-M-천동안산(NMDA)수체뇌염적안전성화가조작성.방법 전첨성관찰연구2012년1월지2015년1월수입선무의원신경내과감호병방적항NMDA수체뇌염환자PE치료적불량반응화료효.결과 공납입9례환자접수PE치료54차,전부(100％)환자경과PE치료후CSF화(혹)혈청중NMDA수체항체적도균유감저혹전위음성,공5례(55.5％)환자림상호전.PE불량반응의차위:불자주운동증가、저혈압、PE관로응혈、체온승고、과민반응화심정맥치관처관구주위삼혈.무치사적엄중불량반응.결론 PE가유효치료항NMDA수체뇌염,병차안전가행.
Objective To explore the safety of plasma exchange (PE) therapy in patients with anti-NMDA receptor encephalitis.Methods Prospective reviews were conducted for the adverse events and therapeutic efficacies of PE therapy in 9 patients with anti-NMDA receptor encephalitis admitted into neurointensive care unit from January 2012 to January 2015.Results A total of 54 PE procedures were performed.The NMDA receptor antibody titer of cerebrospinal fluid (CSF) and/or sera in 9 patients (100％) decreased or turned negative.Five patients (55.5％) demonstrated clinical improvement after PE therapy.And clinical complications included frequent involuntary movements,hypotension,coagulation of PE channel,febricity,allergic response and errhysis around peripheral venous access.Conclusion PE is effective,safe and well-tolerated in patients with anti-NMDA receptor encephalitis.