摘要： 目的 回顾分析抗N-甲基-D-天冬氨酸受体（NMDAR）脑炎患者临床表现，总结其发病特点。方法与结果 共3 例经临床、实验室和影像学检查明确诊断为抗NMDAR 脑炎患者，男性2 例、女性1 例，年龄33 ~ 34 岁，平均33.30 岁。临床主要表现为头痛（2 例），精神异常（3 例），言语障碍（3 例），运动异常（1 例）或幻觉（1 例）；MRI 显示脑回肿胀、颞叶异常信号或脱髓鞘改变；脑电图呈局灶性或弥漫性慢波；脑脊液白细胞计数（3 例）和蛋白定量（2 例）升高。均经甲泼尼龙和免疫球蛋白治疗痊愈。结论 抗NMDAR 脑炎是一种严重但可治性疾病，是临床上可以鉴别且可用血清学方法诊断的疾病。早期诊断和及时治疗有助于改善抗NMDAR 脑炎患者预后。

关键词: 脑炎, 受体, N-甲基-D-天冬氨酸

Abstract: Objective  To study the clinical and laboratory features and diagnosis of the patient with anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis.  Methods The data of clinical features, laboratory findings, and radiological manifestations of 3 patients with anti-NMDAR encephalitis were reviewed and analyzed. Results  Of the 3 patients, 2 were male and one was female. The age was from 33 to 34 years (33.30 years on average). Main symptoms included headache in 2 cases, psychiatric symptoms and speech disorder in 3 cases, different levels of movement disorder in one case and hallucinations in one case. The results of MRI examination revealed gyri swelling, abnormal signal and demyelination of temporal lobe. The EEG showed focal or diffuse slow waves. All cases were confirmed to have the disease by detection of anti-NMDAR antibodies. Both the white blood cell count (3 cases) and protein quantification (2 cases) elevated. No tumor was detected in any of the patients. All patients were coued after receiving immunotherapy with methylprednisolone and human immunoglobulin.  Conclusions   Anti-NMDAR encephalitis is a severe but treatable disorder. The syndrome is highly recognizable clinically and can be confirmed with the demonstration of anti-NMDAR antibodies. Timely diagnosis and treatment may yield a favorable prognosis.

Key words: Encephalitis, Receptors, N-methyl-D-aspartate