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目的探讨Guillain-Barré综合征(GBS)患者CNS内源性免疫反应与CSF蛋白的关系及临床意义。方法收集69例GBS患者的临床资料,采用免疫散射比浊法测定CSF和血清免疫球蛋白G(Ig G)、白蛋白水平,计算CSF白蛋白/血清白蛋白(QALB)、Ig G指数、24 h鞘内Ig G合成率。结果 CSF蛋白正常与偏高患者性别、年龄、残疾量表评分、上呼吸道感染、胃肠感染、肺部感染、近期疫苗接种比率差异无统计学意义。CSF蛋白正常患者CSF蛋白、QALB、Ig G、24 h鞘内Ig G合成率均显著低于CSF蛋白异常患者(均P<0.01),Ig G指数差异无统计学意义。24 h鞘内Ig G合成率正常患者CSF蛋白[0.49(10.84)]g/L显著低于偏高患者[0.98(12.97)]g/L(U=205.50,P<0.01)。24 h鞘内Ig G合成率与CSF蛋白呈正相关(r=0.599,P<0.01)。结论 GBS患者CSF蛋白水平随CNS内源性免疫反应增强而增加,24 h鞘内Ig G合成率有助于GBS的病情监测及预后评估。
Objective To investigate the relationship between CNS endogenous immune response and CSF protein in patients with Guillain-Barré syndrome (GBS) and its clinical significance. Methods The clinical data of 69 patients with GBS were collected. The CSF and serum immunoglobulin G (Ig G) and albumin levels were measured by immune nephelometry. The levels of CSF albumin / serum albumin (QALB), Ig G, h Intrathecal Ig G synthesis rate. Results There was no significant difference in the gender, age, disability scale score, upper respiratory tract infection, gastrointestinal infection, lung infection and recent vaccination rate between patients with normal and high CSF protein. CSF protein, QALB, Ig G and intrathecal Ig G synthesis rate in 24 h were significantly lower than those in normal CSF protein patients (all P <0.01). There was no significant difference in Ig G index. The CSF protein [0.49 (10.84)] g / L in patients with normal intrathecal Ig G synthesis rate at 24 h was significantly lower than that in patients with elevated hypertension [0.98 (12.97)] g / L (U = 205.50, P <0.01). The synthesis rate of intrathecal Ig G in 24 h was positively correlated with CSF protein (r = 0.599, P <0.01). Conclusion CSF protein levels in patients with GBS increased with the increase of endogenous immune response in CNS, and the rate of intrathecal Ig G synthesis in 24 h was helpful to the condition monitoring and prognosis evaluation of GBS.