杨红汤可娜仲星星韩露朱德生管阳太

吉兰-巴雷综合征脑脊液蛋白与面神经瘫痪的相关性☆

杨红*※汤可娜*仲星星*韩露*朱德生△管阳太*

目的探讨吉兰-巴雷综合征（Guillain-Barre Snydrome，GBS）患者脑脊液蛋白与面神经瘫痪的关系及其临床意义。方法 回顾性分析2005年1月至2015年9月我院神经内科确诊的111例GBS患者临床与生化资料，根据面神经瘫痪将患者分为面神经正常组与瘫痪组，比较两组患者间的临床、生化特征；根据脑脊液蛋白值将患者分为脑脊液蛋白正常组、轻度偏高组与异常偏高组，比较3组间面神经瘫痪数量的变化；分析脑脊液蛋白与面神经瘫痪的相关性。结果面神经正常组与瘫痪组之间患者性别、年龄、残疾量表评分（≥3）、上呼吸道感染、胃肠感染、肺部感染及近期疫苗接种史比较无统计学差异（P＞0.05），脑脊液蛋白、免疫球蛋白G（IgG）、脑脊液白蛋白/血清白蛋白（QALB）比较有统计学差异（P＜0.05）；3组不同脑脊液蛋白水平患者面神经瘫痪数量比较有统计学差异（F=3.48，P=0.03）；脑脊液蛋白水平与面神经瘫痪数量呈正相关（r=0.288，P＜0.01）。结论 GBS患者脑脊液蛋白值越高面神经瘫痪发生的可能性越大，脑脊液蛋白有助于GBS患者面神经瘫痪的病情监测。

神经免疫 吉兰-巴雷综合征 脑脊液蛋白 面神经瘫痪

【Abstract】Objectives To explore the correlation between the cerebrospinal fluid protein and facial paralysis in patients with Guillain-Barre syndrome（GBS）.Methods Clinical and biochemical data of 111 patients with GBS in department of neurology from January 2005 to September 2015 were retrospectively analyzed.According to facial paralysis，GBS patients were divided into the facial normal and paralysis groups.Their clinical and biochemical characteristics were compared between the two groups.According to level of cerebrospinal fluid protein，GBS patients were divided into cerebrospinal fluid protein normal，mild high and severe high groups.Incidences of facial paralysis were compared among these three groups.The correlation between the cerebrospinal fluid protein and facial paralysis was analyzed.Results There was no significant difference in gender，age，respiratory infection and other clinical symptoms（P＞0.05），whereas there were statistically significant differences in cerebrospinal fluid protein，immunoglobulin G，and cerebrospinal fluid albumin/serum albumin ratio between the facial normal and paralysis groups（P＜0.05）.Among the three groups by different levels of cerebrospinal fluid protein，there were statistically significant differences in the incidence of facial paralysis （F=3.48，P=0.03）.Cerebrospinal fluid protein was positively correlated with facial paralysis（r=0.288，P＜0.01）.Conclu-sions The incidence of facial paralysis is associated with the levels of cerebrospinal fluid protein.Thus，cerebrospinal fluid protein may be helpful in monitoring of GBS patients with facial paralysis.

【Key words】Neural immune Guillain-Barre Syndrome Cerebrospinal fluid protein Facial paralysis

吉兰-巴雷综合征（Guillain-Barré syndrome，GBS）是一类免疫介导的急性炎性周围神经病，表现为多发神经根水肿及周围神经损害，常伴脑脊液免疫球蛋白水平升高，临床患者可出现面神经瘫痪症状，其发病机制可能与面神经根发生免疫炎性反应引起面神经损伤有关［1］。……