格林-巴利综合征鞘内IgG合成率的观察

Intrathecal IgG synthesis rate in Guillain-Barre syndrome

用火箭电泳法对７１例临床确诊的格林－巴利综合征（ＧＢＳ）和６１例正常对照者的配对血清和脑脊液进行白蛋白（Ａｌｂ）、γ－球蛋白（ＩｇＧ）检测，并计算出每２４小时鞘内ＩｇＧ合成率（Ｓｇｎ－ＩｎＧ）、脑脊液和血清白蛋白的比值（Ａｌｂｃ／Ａｌｂｓ），同时探讨这些指标与临床相的关系。结果发现：病例组脑脊液ＩｇＧ、Ａｌｂ以及Ａｌｂｃ／Ａｌｂｓ、Ｓｙｎ—ＩｇＧ均较对照组升高（Ｐ＜０．０５）。说明本组ＧＢＳ患者血脑屏障破坏和路内ＩｇＧ的自身合成是其脑脊液中ＩｇＧ升高的主要原因。Ｓｙｎ—ＩｇＧ与临床相密切相关（Ｐ＜０．００１）。激素治疗对改善临床症状，降低血脑屏障通透性和Ｓｙｎ—ＩｇＧ有效。

Albumin and gamma immunoglobulin(IgG) of paired cerebrospinal fluid (CSF) and serum (S) samples from 61 normal subjects and 71 patients with Guillain - Barre syndrome (GBS) were measured by rocket immunoelectrophoresis (RIE), and CSF/S albumin ratio and intrathecal IgG synthesis rate were also calculated based on Tourtellotte's formula. The results showed that the mean values of CSF IgG and Albumin,intrathecal IgG synthesis rate and CSF/S albumin ratio in GBS group were significantly higher than that of the normal group (P<O. 05),but there was no significant difference of the mean of serum albumin and IgG between GBS group and noumal controls. It suggests that CSF IgG elevation in the GBS group is due to Blood-brain - barrier dysfunction and IgG synthesis within central nervous system. It was also found that clinical manifestation correlated with the level of IgG synthesis rate. In patients treated with corticosteroid the clinical sign and blood - brain-barrier function were significantly improved than the group untreated with it (P<0.01). IgG synthesis rate in the treated group were significantly lower than. that in untreated group (P<0. 01).