自身免疫性脑炎相关抗体实验室检测现状

doi:10.3969/j.issn.1673-8640.2025.03.002

摘要/Abstract

摘要：

自身免疫性脑炎（AE）是一类以中枢神经系统炎症为主要特征的疾病，临床表现多样，且与其他神经系统疾病有重叠，鉴别诊断具有一定挑战性。目前，越来越多的AE被列为单独的亚型，不同亚型与特定的临床综合征和潜在的致病性自身抗体有关。在实验室检测中，除血液、脑脊液常规检测外，自身抗体检测也可为AE的诊断提供重要依据。AE相关自身抗体的检测方法包括间接免疫荧光法（IFA）、酶联免疫吸附试验（ELISA）和线性免疫印迹法（LIA）。AE相关自身抗体通常靶向神经元抗原，根据抗原检测结果，可将AE分为副肿瘤性AE和抗神经元表面抗原或突触抗原抗体介导的AE两大类。文章从AE的病理机制、AE相关自身抗体的类型、实验室检测技术的进展和自身抗体在AE诊断中的应用4个方面进行综述，以加深临床对AE的认识，为AE的临床诊治提供参考。

关键词: 自身抗体, 自身免疫性脑炎, 实验室检测

Abstract:

Autoimmune encephalitis （AE） refers to a group of disorders characterized by inflammation of the central nervous system （CNS）. Due to its diverse clinical manifestations and overlapping features with other neurological disorders，the differential diagnosis of AE presents significant challenges. At present，an increasing number of AE have been identified as distinct subtypes，and different subtypes were associated with specific clinical syndromes and potentially pathogenic antibodies. In clinical laboratory testing，in addition to routine biochemical examinations of blood and cerebrospinal fluid （CSF），the determination of specific autoantibodies in serum or CSF provides critical diagnostic insights. The main determination methods include indirect immunofluorescence assay （IFA），enzyme-linked immunosorbent assay （ELISA） and line immunoassay （LIA）. These autoantibodies typically target neuronal antigens，categorizing AE into paraneoplastic AE and AE mediated by antibodies against neuronal surface or synaptic antigens. This article comprehensively reviews 4 aspects：the pathological mechanisms of AE，the types of associated autoantibodies，advancements in laboratory determination techniques and the application of autoantibodies in the diagnosis of AE. The aim is to enhance clinical understanding of AE and provide references for its clinical diagnosis and treatment.

Key words: Autoimmune encephalitis, Autoantibody, Clinical laboratory determination

中图分类号:

R446.62

李汉华, 吴亚洲, 翁文浩. 自身免疫性脑炎相关抗体实验室检测现状[J]. 检验医学, 2025, 40(3): 209-217.

LI Hanhua, WU Yazhou, WENG Wenhao. Status of laboratory testing for autoimmune encephalitis-related antibodies[J]. Laboratory Medicine, 2025, 40(3): 209-217.

图/表 1

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