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目的 根据格林 -巴利综合征 (GBS)患儿以周围神经损伤为主 ,伴有中枢神经的免疫病理改变 ,并合并多脏器的功能紊乱及损害探讨格林 -巴利综合征患儿心脏是否存在自身免疫现象。方法 采用ELISA检测 32例格林 -巴利综合征患儿 ,112例病毒性心肌炎 (VM)患儿和 6 0例正常健康儿童血清心肌线粒体IgG (AMMIgG ) ,并检测了GBS的脑脊液 (CSF)中髓鞘碱性蛋白 (MBP)IgG和寡克隆IgG。结果 GBS组血清线粒体IgG阳性率6 8 75 % ,VM组 5 6 2 5 % ,两组与正常对照组间差异有显著性意义。对照组 6 0例全部阴性。表明GBS在周围神经和中枢神经受累的同时也有心脏的损害 ,且心肌受损率高于病毒性心肌炎组。GBS与VM组间血清AMMIgG阳性率差异无显著性意义 (χ2 =1 5 93,P >0 0 5 )。 8/2 2例阳性者有CSF中MBP -IgG出现 ,GBS患儿血清AMMIgG阳性者与阴性者间的CSF中寡克隆IgG阳性率差异有显著性意义 χ2 =6 4 ,P <0 0 2 0 。GBS患儿血清AMMIgG阳性者CSF中寡克隆IgG阳性率 6 2 5 %低于阴性者的 18 75 %。结论 提示部分GBS患儿存在心肌免疫性损伤。因此 ,必要的AMMIgG检测 ,有助于了解GBS患儿心脏功能和体内的免疫状态 ,并起到监测自身免疫反应的作用
OBJECTIVE According to the peripheral nerve injury in children with Guillain-Barre Syndrome (GBS), accompanied by the immunopathological changes of the central nervous system, and complicated with multiple organ dysfunction and damage to explore whether the heart of children with Guillain-Barre syndrome There is an autoimmune phenomenon. Methods The levels of serum myocardial mitochondrial IgG (AMMIgG) in 32 children with Guillain-Barre syndrome, 112 children with viral myocarditis (VM) and 60 children with normal health were detected by ELISA. The levels of serum myocardial mitochondrial IgG (AMMIgG) Myelin basic protein (MBP) IgG and oligoclonal IgG. Results The positive rate of serum mitochondrial IgG was 6 8 75% in GBS group and 56 52% in VM group, there was significant difference between the two groups and the normal control group. Control group 60 cases were all negative. The results showed that GBS also had heart damage in peripheral nerve and central nervous system, and the myocardial damage rate was higher than that in viral myocarditis group. There was no significant difference in the positive rate of serum AMMIgG between GBS and VM (χ2 = 1593, P> 0.05). There were significant differences in the positive rate of oligoclonal IgG in CSF among 8/2 2 positive patients, MBP-IgG in CSF, positive CSF IgG in AMI-IgG positive patients and GBS children with χ2 = 6 4, P <0.00 2 . The positive rate of oligoclonal IgG in CSF with AMMIgG-positive serum of GBS children was 62.5% lower than that of negative ones. Conclusions Some children with GBS have myocardial immune injury. Therefore, the necessary AMMIgG test can help understand the cardiac function and immune status in children with GBS and play an important role in monitoring the autoimmune response