论著JClinNeurol,,June2023,Vol.36,No.3180·成人自身免疫性胶质纤维酸性蛋白星形细胞病12例临床特征分析张颖，卢宏【摘要】】目的分析成人自身免疫性胶质纤维酸性蛋白（GFAP)星形细胞病的临床特点、辅助检查、治疗及预后，以期提高对该疾病的认识。方法回顾性分析郑州大学第一附属医院2019年9月至2022年5月确诊的12例成人自身免疫性GFAP星形细胞病患者的临床资料。结果12例患者中,男性9例,女性3例，主要表现为发热、头痛、肢体无力、肢体麻木等。头颅MRI提示多发点状或斑片状T,WI、Flair高信号，可累及侧脑室旁、额叶、基底节区等。部分患者脊髓受累，脊髓MRI显示条片状T,WI高信号。CSFGFAP抗体均为阳性，CSF白细胞、淋巴细胞、蛋白含量、白蛋白商值及24hIgG鞘内合成率多升高，部分患者寡克隆区带阳性。5例患者合并其他自身抗体,6例合并低钠血症,8例血尿酸下降,4例血清IL-6下降,3例EMG存在异常。给予经验性免疫治疗,大多患者预后良好,部分留有功能障碍。结论成人自身免疫性GFAP星形细胞病临床表现具有异质性,重症患者进展较快。头MRI和（或）脊髓MRI及CSF检查可辅助诊断，免疫治疗效果好。【关键词】胶质纤维酸性蛋白；自身免疫性星形细胞病；临床特征【中图分类号】R744.5【文献标识码】A【文章编号】1004-1648(202303-0180-05Analysisofclinicalcharacteristicssof12casesofadultautoimmuneglialfibrillaryacidicproteinastrocytopathyZHANGYing,LUHong.DepartmentofNeurology,theFirstAffliatedHospitalofZhengzhouUniversity,Zhengzhou450000,ChinaAbstract:ObjectiveToanalyzetheclinicalcharacteristics,ancillaryexaminations,treatmentandprognosisofautoimmuneglialfibrillaryacidicprotein(GFAP)astrocytopathyinadults,inordertoimprovetheunderstandingofthedisease.MethodsTheclinicaldataof12adultpatientswithautoimmuneGFAPastrocytopathydiagnosedintheFirstAffiliatedHospitalofZhengzhouUniversityfromSeptember2019toMay2022wereretrospectivelyanalyzed.ResultsTherewere9malesand3femalesin12patients,mainlypresentingwithfever,headache,limbweakness,limbnumbness,etc.ThecranialMRIsuggestedmultipledotsorpatchesofT,WIandFlairhyperintensities,whichinvolvedthelateralventricle,frontallobeandbasalganglia,etc.ThespinalcordwasinvolvedinsomepatientsandthespinalMRIshowedstripsofT,WIhyperintensities.GFAPanti...
