目的：探讨抗 N- 甲基 -D- 天冬氨酸受体（N-methyl-D-aspartate receptor，NMDAR）脑炎患者的临床特征及预后相关因素。

方法：收集 28 例抗 NMDAR 脑炎患者的人口学资料、临床表现、实验室及影像学检查结果、治疗经过以及出院时及随访 6个月时的改良Rankin 量表（modified Rankin Scale，mRS）评分。应用单因素分析及logistic回归模型评估与出院及随访 6个月时mRS评分相关的因素。

结果：单因素分析结果显示，出院时 mRS 与有无意识障碍、颅内压和入住 ICU 的时间显著相关（P=0.009，P=0.029，P=0.037），随访 6 个月时的 mRS 与有无意识障碍、血清抗NMDAR 抗体效价和脑脊液白细胞数显著相关（P=0.046，P=0.013，P=0.028）。多因素分析结果显示，颅内压升高是出院时 mRS 评分＞ 2 分的独立危险因素（比值比：1.016 ； P=0.027），脑脊液白细胞数增加是随访 6 个月时 mRS 评分＞ 2 分的独立危险因素（比值比：1.029；P=0.044）。

结论：颅内压和脑脊液白细胞数是抗 NMDAR 脑炎的预后相关因素。应对早期颅内压及脑脊液白细胞数明显增加的患者给予足够的重视，及时给予相应的治疗，以期改善这类患者的预后。

Objective: To describe the clinical features and evaluate the prognostic factors of patients with anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis.

Methods: The demographic data, clinical manifestations, laboratory and imaging findings, treatment process and modified Rankin Scale (mRS) scores of 28 patients with anti-NMDAR encephalitis were collected. Univariate analysis and logistic regression model were used to evaluate the factors related to mRS score at discharge and 6-month follow-up.

Results: Univariate analysis showed that mRS score at discharge was significantly correlated with unconsciousness, intracranial pressure and length of intensive care unit (ICU) stay (P=0.009, P=0.029, P=0.037). mRS score at 6-month follow-up was significantly correlated with unconsciousness, serum anti-NMDAR antibody titer and leukocyte count in cerebrospinal fluid (P=0.046, P=0.013, P=0.028). Multivariate analysis showed that elevated intracranial pressure was an independent risk factor for mRS score>2 at discharge (odds ratio: 1.016; P=0.027), and increased number of leukocytes in cerebrospinal fluid was an independent risk factor for mRS score>2 at 6-month follow-up (odds ratio: 1.029; P=0.044).

Conclusion: Intracranial pressure and leukocyte count in cerebrospinal fluid are prognostic factors of anti-NMDAR encephalitis. Enough attention should be paid to patients with significant increase in early intracranial pressure and the number of leukocytes in cerebrospinal fluid, and corresponding treatment should be given in time, in order to improve the prognosis of these patients.