GUILLAIN-BARRE-SYNDROME IN NORTHERN CHINA - RELATIONSHIP TO CAMPYLOBACTER-JEJUNI INFECTION AND ANTI-GLYCOLIPID ANTIBODIES
GUILLAIN-BARRE-SYNDROME IN NORTHERN CHINA - RELATIONSHIP TO CAMPYLOBACTER-JEJUNI INFECTION AND ANTI-GLYCOLIPID ANTIBODIES
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DOI：
10.1093/brain/118.3.597
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发表时间：
1995-06-01
期刊：
影响因子：
14.5
通讯作者：
MCKHANN, GM
中科院分区：
文献类型：
--
作者：
HO, TW;MISHU, B;MCKHANN, GM
格林-巴利综合征主要是一种急性炎症性脱髓鞘性多发性神经病。我们在中国北方对格林-巴利综合征的经验不同于传统的概念。在电生理学和病理学上，我们的患者中的肥大具有运动轴突变性，伴有轻微的细胞炎症，我们称之为“急性运动轴突神经病”（AMAN）。本研究旨在前瞻性地描述格林-巴利综合征的临床、电生理和血清学特征，该综合征在中国北方临床上被定义。1991年和1992年，我们对129例格林-巴利综合征进行了电诊断。AMAN型占65%，AIDP型占24%，11%无法分类。对于1992年1月至10月的38例患者，我们进行了空肠弯曲菌和糖脂抗体的血清学测定。在这38名患者中，55%患有AMAN，32%患有AIDP，13%无法分类。38例中66%有近期C.空肠感染与16%的乡村对照相比（P = 0.001）。76%的AMAN患者和42%的AIDP患者血清学阳性。格林-巴利综合征患者IgG抗GM 1抗体阳性率高于农村对照组（42%比6%; P < 0.01）。然而，在疾病类型、AMAN或AIDP、抗糖脂抗体或C。空肠抗体根据电生理学标准，中国北方的格林-巴利综合征可分为两种主要形式：AIDP和AMAN。AMAN型更常见，在每年夏季格林-巴利综合征的爆发中占主导地位。在中国北方临床诊断的格林-巴利综合征中，C.空肠可能起重要作用，尤其是在. AMAN的形式。
Guillain-Barre syndrome has been considered to be primarily an acute inflammatory demyelinating polyneuropathy (AIDP). Our experience with Guillain-Barre syndrome in northern China differs from the traditional concept. Electrophysiologically and pathologically, mast of our patients have motor axonal degeneration with minimal cellular inflammation, which we have termed 'acute motor axonal neuropathy' (AMAN). The current studies were undertaken to characterize prospectively the clinical, electrophysiological, and serological features of Guillain-Barre syndrome, defined clinically in northern China. In 1991 and 1992, we characterized by electrodiagnostic criteria 129 Chinese patients with Guillain-Barre syndrome. The AMAN form was present in 65% of patients, the AIDP form in 24% and 11% were unclassifiable. For the 38 patients who presented from January to October 1992, we performed serological assays for antibodies to Campylobacter jejuni and to glycolipids. Of these 38 patients, 55% had AMAN, 32% had AIDP and 13% were unclassifiable. Sixty-six percent of the 38 had serological evidence of recent C. jejuni infection as compared with 16% of village controls (P = 0.001). Seventy-six percent of AMAN patients and 42% of AIDP patients were seropositive. IgG anti-GM1 antibodies were more frequent in Guillain-Barre syndrome patients compared with village controls (42% versus 6%; P < 0.01). However no statistically significant correlations were found between the pattern of disease, AMAN or AIDP, anti-glycolipid antibodies, or C. jejuni antibodies. Based on electrophysiological criteria, Guillain-Barre syndrome in northern China can be divided into two predominant forms: AIDP and AMAN. The AMAN form is more common and predominates in the yearly summer outbreaks of Guillain-Barre syndrome. In clinically diagnosed Guillain-Barre syndrome in northern China, C. jejuni may play an important role, especially in. the AMAN form.