格林-巴利综合征患者神经系统感染病毒抗体谱分析

Analysis of antibody profiles of nervous system virus infections in patients with Guillain-Barré syndrome

目的了解格林-巴利综合征(GBS)患者的神经系统病毒抗体谱分布特征,探讨GBS与病毒感染之间的关系。方法对首都医科大学附属北京天坛医院2013-2017年确诊为GBS的54例患者的血清及脑脊液进行神经系统感染病毒抗体检测,从性别、年龄、急慢性等方面对病毒抗体阳性率进行分析。结果 54例GBS患者血清和脑脊液中不同抗体的检出率存在较大差异,其中巨细胞病毒-免疫球蛋白G(CMV-IgG)抗体在血清及脑脊液中的检出率(98.1%、68.5%)最高。血清中检测到单纯疱疹病毒(HSV)1+2IgM抗体阳性2例,脑脊液中检测到HSV1+2IgM抗体阳性1例(其中1例为血清和脑脊液双阳性),血清中检测到EB病毒早期抗原(EBEA)-IgM阳性1例。GBS急性组患者血清风疹病毒(RUB)IgG抗体和弓形虫(TOX)IgG抗体阳性率(92.5%、37.5%)显著高于GBS慢性组患者(71.4%、7.1%),差异均有统计学意义(P<0.05)。结论 HSV和EB病毒可能与GBS的发病具有相关性。相较于慢性GBS,RUB和TOX前驱感染可能与急性GBS更具有相关性,但仍需进一步相关研究证实。

Objective To understand the distribution characteristics of the virus antibodies of Guillain-Barré syndrome（GBS）and explore the relationship between GBS and virus infections.Methods Virus antibodies in serum and cerebrospinal fluid were detected in 54 cases of GBS diagnosed by Beijing Tiantan Hospital Affiliated to Capital Medical University from 2013 to 2017.The positive rate of virus antibodies was analyzed in different aspects,including gender,age,acute or chronic.Results The detection rates of different antibodies in serum or cerebrospinal fluid of 54 GBS patients were quite different.The positive rate of CMV-IgG antibodies in serum（98.1%）and cerebrospinal fluid（68.5%）were the highest.There were 2 cases of herpes simplex virus（HSV）1＋2 IgM antibody positive in serum and 1 case of HSV1＋2 IgM antibody positive in cerebrospinal fluid（1 case was double positive in serum and cerebrospinal fluid）,and 1 case was EB virus early antigen（EBEA）-IgM positive in serum.Results showed that the positive rates of RUBIGG antibody and TOXIGG antibody in the serum of acute group（92.5%,37.5%）were significantly higher than those of chronic patients（71.4%,7.1%）,and the differences were statistically significant（P<0.05）.Conclusion HSV and EB virus may be related to the pathogenesis of GBS.Compared with chronic GBS,the preceding infection of RUB and TOX may be more correlated with acute GBS.However,further related research is still needed.