复发性乙型肝炎病毒相关性吉兰－巴雷综合征的发病机制和治疗方法探讨（病例报告及文献复习）

A study of the pathogenesis and treatment of HBV-associated recurrent Guillain-Barre syndrome

目的：探讨乙型肝炎病毒（ HBV）相关性复发性吉兰－巴雷综合征（ GBS）的发病机制和治疗方法。方法回顾性分析1例HBV相关性复发性GBS患者的临床资料及诊治经过，并复习相关文献。结果 HBV相关性GBS患者的脑脊液中HBV标志物阳性，糖皮质激素疗效不明显，静脉注射免疫球蛋白、血浆置换有效，但不能阻止复发，而抗病毒治疗能预防复发却有使GBS加重的可能性。结论 HBV相关性复发性GBS的发病可能与HBV诱导的免疫反应以及机体的免疫状态有关，GBS的常规治疗方法有效，抗HBV治疗能阻止复发但可能加重病情，而糖皮质激素疗效不确切。

Objective To investigate the pathogenesis and treatment of HBV -associated Guillain -Barre syn-drome.Methods Clinical data and therapeutic reports from a patient with HBV-associated recurrent Guillain-Barre syndrome were analyzed retrospectively, while relevant literature was reviewed.Results The biomarkers of HBV were detected in the cerebrospinal fluid samples of the patient with HBV-associated Guillain-Barre syndrome.Administra-tion of glucocorticoids could not result in obvious efficacy.Intravenous injection of immunoglobulin and plasma exchange were found to be effective, which however could not prevent it from relapse.After anti-viral therapy, GBS was preven-ted but might be aggravated.Conclusions The onset of HBV-associated GBS may be related to HBV-induced im-mune response and immune status.The efficacy of glucocorticoids treatment can not be determined.Routine therapy is ef-fective for GBS.Anti-viral therapy can block the relapse of GBS but might aggravate the patient＆#39;s condition.