【摘要】 目的 探讨抗NMDAR脑炎患者循环MMP-9水平与疾病严重程度及预后的关系。方法连续纳入40例确诊为抗NMDAR脑炎的患者，根据入院时mRS评分分为病情较轻组（n=18）与症状较重组（n=22）。所有患者均于治疗前采集血清及脑脊液标本，使用酶联免疫吸附法检测MMP-9水平，比较2组基线临床资料及MMP-9水平，分析疾病严重程度的独立影响因素，通过ROC曲线评估MMP-9对疾病严重程度的预测价值。进一步根据发病6个月后mRS评分将患者分为预后良好组（n=25）与预后不良组（n=12），分析血清及脑脊液MMP-9水平与临床预后的关系。结果 症状较重组患者循环MMP-9水平均显著高于病情较轻组。多因素Logistic回归分析显示，高水平MMP-9是疾病严重程度的独立影响因素（P<0.05）。预后不良组MMP-9水平亦显著高于预后良好组，高水平MMP-9是预后不良的独立预测因子（P<0.05）。ROC曲线分析表明，循环MMP-9水平对疾病严重程度和预后结局均具有较高的预测价值。结论 抗NMDAR脑炎患者循环MMP-9水平与较重症状及不良预后显著相关，MMP-9可能是评估病情和预测预后的潜在生物标志物。更多还原

【Abstract】 Objective To investigate the relationship between circulating MMP-9 levels and disease severity and prognosis in patients with anti-NMDAR encephalitis.Methods A total of 40 patients diagnosed with anti-NMDAR encephalitis were consecutively enrolled and divided into mild group(n=18)and severe group(n=22) based on modified Rankin scale scores at admission. Serum and CSF samples were collected before treatment. MMP-9 levels were measured using enzyme-linked immunosorbent assay. Differences in clinical baseline data and MMP-9 levels between both groups were compared. Independent influencing factors for disease severity were identified using multivariate Logistic regression,and the predictive value of MMP-9 for disease severity was evaluated by ROC curve analysis. Patients were further categorized into favorable prognosis group(n=25)and poor prognosis group(n=12)according to mRS scores at 6 months after onset. The association between serum/CSF MMP-9 levels and clinical prognosis was analyzed.Results Circulating MMP-9 levels were significantly higher in the severe group than those in the mild group. Multivariate Logistic regression indicated that high MMP-9 level was an independent risk factor for disease severity(P<0.05). MMP-9 levels were also significantly elevated in the poor prognosis group compared to the favorable prognosis group,and high MMP-9 was an independent predictor of poor prognosis(P<0.05). ROC analysis demonstrated that circulating MMP-9 levels had high predictive value for both disease severity and prognosis.Conclusion Elevated circulating MMP-9 levels are significantly associated with more severe symptoms and poorer prognosis in anti-NMDAR encephalitis,suggesting that MMP-9 may serve as a potential biomarker for assessing disease severity and predicting outcomes.更多还原