乙肝重叠戊肝合并格林-巴利综合征1例报告

Superinfection of HBV and HEV combined with Guillain-Barre syndrome: one case report

目的认识乙肝重叠戊肝合并格林-巴利综合征(GBS)的临床特征,提高对该病的诊治。方法回顾分析1例乙肝重叠戊肝合并格林-巴利综合征的临床,生化学指标及神经电生理学表现,并文献复习。结果该患者纳差,乏力,尿黄,在肝功能好转的过程中,出现口、眼歪斜,间断流涎,双下肢及双足麻木感,渐加重,出现不能站立,双下肢无力,对称性软瘫,脑脊液检查出现蛋白-细胞分离,肌电图提示周围神经损害,双侧面神经损害,根据病史,临床,体征及相关检查,该患者诊断为乙肝重叠戊肝合并格林-巴利综合征,给予乙肝抗病毒治疗,激素,免疫球蛋白等治疗,患者病情基本缓解。结论乙肝重叠戊肝可并发格林-巴利综合征,及早对重叠病毒感染的干预治疗及优化治疗能否缩短格林-巴利综合征的病程需要进一步的探讨。

Objective To understand the clinical features of Guillain-Barre syndrome（GBS）of HBV and HEV,to improve the diagnosis and treatment of the disease.Methods A retrospective analysis of one case of superinfection of HBV and HEV combined with GBS was made of its clinical,biochemical and electrophysiological findings,and literature review was conducted.Results The patient had anorexia,fatigue,and yellow urine.In the process of the improvement of liver function,the patient showed facial paralysis,intermittent dribbling,and lower limbs and feet numbness,which gradually worsened to inability to stand,lower extremity weakness,and symmetrical flaccid paralysis.Cerebrospinal tests indicated albumincytological dissociation.The EMG indicated peripheral nerve damage and bilateral facial nerve damage.According to medical history,clinical signs and examination results,the patient was diagnosed as superinfection of HBV and HEV combined with Guillain-Barre syndrome.With hepatitis B antivirus,hormone,and immune globulin treatment,the patient got better.Conclusions HBV and HEV can be complicated by GBS.Whether early intervention of superinfection and optimal treatment can shorten the course of Guillain-Barre syndrome still needs further study.