IgA、IgM与吉兰巴雷综合征患儿预后的相关性

Correlations between IgA and IgM and the prognosis of children with Guillain-Barrésyndrome

目的探讨免疫球蛋白A(IgA)、免疫球蛋白M(IgM)的表达与不同类型吉兰巴雷综合征患儿预后的相关性。方法选取2017年6月至2019年8月就诊于河北省儿童医院神经内科的60例吉兰巴雷综合征患儿作为研究对象,根据分类标准分为脱髓鞘型组(30例)与轴索型组(30例);同期选取在该院儿童保健科健康体检的20例儿童作为对照组。采用免疫散射比浊法检测两组儿童血清IgA、IgM水平;多因素Logistic回归分析影响吉兰巴雷综合征患儿预后的因素。结果轴索型组血清IgA、IgM阳性率均高于对照组(χ^(2)值分别为23.558、10.526),脱髓鞘型组血清IgA阳性率高于对照组(χ^(2)=9.780),脱髓鞘型组血清IgA、IgM阳性率均低于轴索型组(χ^(2)值分别为4.800、5.455),差异均有统计学意义(P<0.05)。IgA、IgM与脱髓鞘型吉兰巴雷综合征患儿预后有关(r_(s)值分别为0.468、0.539,P<0.05);IgA、IgM与轴索型吉兰巴雷综合征患儿预后有关(r_(s)值分别为0.380、0.791,P<0.05);轴索型(OR=1.901,95%CI:1.374~2.631)、IgA阳性(OR=1.954,95%CI:1.268~3.012)、IgM阳性(OR=1.800,95%CI:1.139~2.846)是影响吉兰巴雷综合征患儿发生不良预后的独立危险因素(P<0.05)。结论IgA阳性、IgM阳性可能与脱髓鞘型、轴索型吉兰巴雷综合征患儿不良预后有关。

Objective To explore the correlations between the expression of immunoglobulin A(IgA)and immunoglobulin M(IgM)and the prognosis of children with different types of Guillain-Barrésyndrome.Methods A total of 60 children with Guillain-Barrésyndrome who visited in the department of neurology,Hebei Children′s Hospital from June 2017 to August 2019 were selected as the research objects.They were divided into the demyelinating group(30 cases)and axonal group(30 cases)according to the classification criteria.At the same time,20 healthy children doing physical examination in the department of child health care in this hospital were selected as the control group.The levels of IgA and IgM in serum were detected by immunoturbidimetric method.In addition,multivariate Logistic regression analysis was used to analyze the prognostic factors of children with Guillain-Barrésyndrome.Results The positive rates of serum IgA and IgM in the axonal group were higher than those in the control group(χ^(2)=23.558 and 10.526,respectively),the positive rate of serum IgA in the demyelinating group was higher than that in the control group(χ^(2)=9.780),the positive rates of IgA and IgM in the demyelinating group were both lower than those in the axonal type group(χ^(2)=4.800 and 5.455,respectively),and the differences were statistically significance(P<0.05).The levels of IgA and IgM were associated with the prognosis of demyelinating Guillain-Barré syndrome(r_(s)=0.468 and 0.539,respectively,P<0.05).The levels of IgA and IgM were correlated with the prognosis of axonal Guillain-Barré syndrome(r_(s)=0.380 and 0.791,respectively,P<0.05).The axonal type(OR=1.901,95%CI:1.374-2.631),positive IgA(OR=1.954,95%CI:1.268-3.012),and positive IgM(OR=1.800,95%CI:1.139-2.846)were the independent risk factors of poor prognosis in children with Guillain-Barrésyndrome(P<0.05).Conclusion Positive IgA and positive IgM may be related to the poor prognosis of children with demyelinating and axonal Guillain-Barrésyndrome.