吉兰-巴雷综合征患者神经系统感染病原体抗体检测情况分析

An Analysis of the Detection Status of the Antibodies to Pathogens of Nervous System Infections in Guillain-BarréSyndrome Patients

目的了解吉兰-巴雷综合征(Guillain-Barrésyndrome,GBS)患者血清中神经系统感染病原体抗体的检测情况,探讨病原体感染与GBS发生的关系。方法选取93例GBS患者为研究对象,以同期99例中枢神经系统其他疾病患者作为对照组,分别测定血清中巨细胞病毒(cytomegalovirus,CMV)、EB病毒(Epstein Barr virus,EBV)、单纯疱疹病毒(herpes simplex virus,HSV)-1、HSV-2、风疹病毒(rubella virus,RV)、弓形虫(toxoplasma gondii,TOX)及柯萨奇病毒(coxsackievirus,COX)等7种病原体的14种IgG及IgM抗体,并进行脑脊液常规及生化检测。结果93例GBS患者脑脊液检查表现为典型的蛋白-细胞分离现象,而糖及氯化物含量与对照组差异无统计学意义。两组患者血清中CMV IgG检出率最高,各病原体IgM抗体检出较少,未检测到RV IgM、TOX IgM、EBVCA-IgM及COX IgM等抗体。与对照组相比,93例GBS患者血清中HSV-2 IgG、TOX IgG检出率明显增高,差异有统计学意义(P<0.05),其他病原体抗体在两组间的检出率差异无统计学意义(P>0.05)。对两组患者同时检出多种病原体抗体情况进行分析,GBS组同时检出6种病原体相应IgG或IgM抗体的检出率明显高于对照组,差异有统计学意义(P<0.05)。结论HSV-2和TOX感染可能与GBS发病有关联,但仍需进一步研究证实。

Objective To evaluate the detection results on the antibodies to pathogens of nervous system infections in Guillain-BarréSyndrome patients’serums,and to explore the relationship between pathogens infections and genesis of Guillain-BarréSyndrome.Methods A total of 93 GBS patients were selected as the research targets,while 99 patients with other central nervous system diseases at the same time were selected as the control group.The 14 IgM and IgG antibodies to 7 pathogens in serum samples,including cytomegalovirus(CMV),Epstein Barr virus(EBV),herpes simplex virus(HSV)-1,HSV-2,rubella virus(RV),toxoplasma gondii(TOX)and coxsackievirus(COX),were detected,and cerebrospinal fluid(CSF)routine and biochemical examination were performed.Results The results of CSF examination indicated typical albuminocytologic dissociation in 93 GBS patients,and there was no significant difference in glucose and chlorides between GBS patients and the control group(P>0.05).The detection rate of CMV IgG was the highest in two groups,and the IgM antibodies to each pathogen were rarely detected,and RV IgM,TOX IgM,EBVCA-IgM and COX IgM were not found.The detection rates of HSV-2 IgG and TOX IgG in 93 GBS patients’serum were significantly higher than those of the control group(P<0.05),and there was no significant difference in other antibodies between 2 groups(P>0.05).We analyzed the situation that several pathogens antibodies were detected simultaneously in one sample,and found that the detection rate of that 6 pathogens corresponding antibodies were detected simultaneously in GBS patients were significantly higher than the control group(P<0.05).Conclusion There could be a relationship between infections of HSV-2 and TOX and pathogenesis of Guillain-BarréSyndrome,but further research is needed to confirm.