[1]李婷婷),张迎娜),吕 杰),等.河南省抗GQ1b抗体综合征患者临床特点分析[J].郑州大学学报(医学版),2019,(02):231-235.[doi:10.13705/j.issn.1671-6825.2018.09.123]
 LI Tingting),ZHANG Yingna),LYU Jie),et al.Clinical characteristics of patients with anti-GQ1b antibody syndrome in Henan Province[J].JOURNAL OF ZHENGZHOU UNIVERSITY(MEDICAL SCIENCES),2019,(02):231-235.[doi:10.13705/j.issn.1671-6825.2018.09.123]
点击复制

河南省抗GQ1b抗体综合征患者临床特点分析()
分享到:

《郑州大学学报(医学版)》[ISSN:1671-6825/CN:41-1340/R]

卷:
期数:
2019年02期
页码:
231-235
栏目:
应用研究
出版日期:
2019-03-20

文章信息/Info

Title:
Clinical characteristics of patients with anti-GQ1b antibody syndrome in Henan Province
作者:
李婷婷1)张迎娜2)吕 杰2)赵 雪2)张 婧2)孟 云1)任 璐1)方 华2)杨俊红3)张运克3)高 峰2)白宏英1)
1)郑州大学第二附属医院神经内科 郑州 450014 2)郑州大学医药科学研究院神经免疫学研究室 郑州 450052 3)河南中医药大学第一附属医院脑病科 郑州 450008
Author(s):
LI Tingting1)ZHANG Yingna2)LYU Jie2)ZHAO Xue2)ZHANG Jing2)MENG Yun1)REN Lu1)FANG Hua2)YANG Junhong3)ZHANG Yunke3) GAO Feng2)BAI Hongying1)
1)Department of Neurology, the Second Affiliated Hospital,Zhengzhou University, Zhengzhou 450014 2)Department of Neuroimmunology Research, Institute of Medical and Pharmaceutical Sciences, Zhengzhou University, Zhengzhou 450052 3)Department of Encephalopathy, the First Affiliated Hospital,Henan University of Traditional Chinese Medicine, Zhengzhou 450008
关键词:
抗GQ1b抗体综合征 临床特点 河南省
Keywords:
anti-GQ1b antibody syndrome clinical features Henan Province
分类号:
R745
DOI:
10.13705/j.issn.1671-6825.2018.09.123
摘要:
目的:分析河南省抗GQ1b抗体综合征患者的临床特点。方法:对815例临床怀疑周围神经病患者的血清进行抗神经节苷脂抗体检测,分析确诊为抗GQ1b抗体综合征的22例患者的临床特点。将22例患者按血清是否单一抗GQ1b抗体阳性分为2组,分析两组间临床表现不同点; 将患者按应用一线免疫药物治疗(17例)和临床对症治疗(5例)分为2组,比较2组疗效的差异。结果:22例患者中男10例,女12例,有前驱感染病史14例,主要临床表现为四肢无力、腱反射减弱或消失、球麻痹; 脑脊液蛋白-细胞分离9例。血清仅抗GQ1b抗体1项阳性者4例,均无意识障碍发生; 多抗体阳性18例,其中伴有意识障碍发生的有5例。一线免疫治疗较临床对症治疗疗效更好(P=0.018)。4例患者经一线免疫治疗8~12 d后血清抗GQ1b抗体转阴性。结论:抗GQ1b抗体综合征临床症状复杂,其中意识障碍的发生可能有多种抗体共同参与,根据临床特点、脑脊液检查和血清GQ1b抗体可明确诊断; 给予人免疫球蛋白或激素治疗预后良好。
Abstract:
Aim:To analyze the clinical features of patients with anti-GQ1b antibody syndrome in Henan Province.Methods:The anti-ganglioside antibody was detected in 815 patients with clinically suspected peripheral neuropathy, and the clinical features of 22 patients diagnosed as anti-GQ1b antibody syndrome were analyzed. The 22 patients were allocated into two groups based on whether their serum was positive for the single anti-GQ1b antibody,and the clinical manifestations were analyzed.The 22 patients were allocated into two groups according to the application of first-line immunotherapy(17 cases)and clinical symptomatic treatment(5 cases), and the non-parametric Kruskal-Wallis test was used to analyze the difference treatment effects.Results:Among the 22 patients, 10 were male and 12 were female. There were 14 cases of pre-infection history. The main clinical manifestations were limb weakness, decreased or absent tendon reflex, and bulbar paralysis. Furthermore, cerebrospinal fluid protein-cell separation was observed in 9 cases. Only 4 patients were positive for single anti-GQ1b antibody, all of whom had not conscious disorder.Additionally, 18 patients were positive for multiple antibodies, of whom 5 showed disturbance of consciousness. First-line immunotherapy was more effective than clinical symptomatic treatment, and the difference was statistically significant(P=0.018). Four patients were negative for serum anti-GQ1b antibody after 8~12 days of first-line immunotherapy.Conclusion:The clinical symptoms of anti-GQ1b antibody syndrome are complex. Among them, disturbance of consciousness may be caused by multiple antibodies. The diagnosis can be confirmed by clinical features, cerebrospinal fluid examination, and serum GQ1b antibody. The prognosis of patients with human immunoglobulin or hormone therapy is good.

参考文献/References:

[1] ODAKA M,YUKI N,HIRATA K.Anti-GQ1b IgG antibody syndrome: clinical and immunological range[J].J Neurol Neurosurg Psychiatry,2001,70(1):50
[2] 黄诚,秦新月.抗GQ1b抗体综合征的研究进展[J].中华神经科杂志,2016,49(1):75
[3] MATSUI N,NODERA H, Kuzume D,et al. Guillain-Barré syndrome in a local area in Japan, 2006-2015: an epidemiological and clinical study of 108 patients[J]. Eur J Neurol,2018,25(5):718
[4] SHAHRIZAILA N,YUKI N.Bickerstaff brainstem encephalitis and Fisher syndrome: anti-GQlb antibody syndrome[J].J Neurol Neurosurg Psychiatry,2013,84(5):576
[5] 李海峰.Guillain-Barre综合征和Miller Fisher综合征的新诊断分类和标准[J].中国神经免疫学和神经病学杂志,2014,21(6):441
[6] VAN SWIETEN JC,KOUDSTAAL PJ,VISSER MC,et al.Interobserver agreement for the assessment of handicap in stroke patients[J].Stroke,1988,19(6):604
[7] ODAKA M,YUKI N,YAMADA M,et al.Biekerstaff's brainstem encephalitis: clinical features of 62 cases and a subgroup associated with Guillain-Barré syndrome[J].Brain,2003,126(Pt 10):2279
[8] MORI M,KUWABARA S,YUKI N.Fisher syndrome: clinical features, immunopathogenesis and management[J].Expert Rev Neurother,2012,12(1):39
[9] YUKI N,SHAHRIZAILA N.How do we identify infectious agents that trigger Guillain-Barre syndrome, Fisher syndrome and Bickerstaff brainstem encephalitis?[J].J Neurol Sci,2011,302(1/2):1
[10]孙青.吉兰巴雷综合征神经电生理研究[D].北京:北京协和医学院中国医学科学院 北京协和医学院 中国医学科学院 清华大学医学部,2013.
[11]LIU JX,WILLISON HJ,PEDROSA-DOMELLOF F.Immunolocalization of GQ1b and related gangliosides in human extraocular neuromuscular junctions and muscle spindles[J].Invest Ophthalmol Vis Sci,2009,50(7):3226
[12]KOGA M,YOSHINO H,MORIMATSU M,et al.Anti-GT1a IgG in Guillain-Barré syndrome[J].J Neurol Neurosurg Psychiatry,2002,72(6):767
[13]韩彤立,杨欣英.吉兰-巴雷综合征谱系疾病的诊断[J].中华实用儿科临床杂志,2016,31(12):884
[14]FUKAMI Y,WONG A,FUNAKOSHI K,et al.Anti-GQ1b antibody syndrome: anti-ganglioside complex reactivity determines clinical spectrum[J].Eur J Neurol,2016, 23(2):320
[15]GUISSET F,FERREIRO C,VOETS S,et al.Anti-GQ1b antibody syndrome presenting as acute isolated bilateral ophthalmoplegia: report on two patients and review of the literature[J].Eur J Paediatr Neurol,2016,20(3):439
[16]马莲,张其梅.4例Miller Fisher综合征临床分析[J].神经损伤与功能重建,2018,13(1):46
[17]MCGONIGAL R,CUNNINGHAM ME,YAO DA,et al.C1q-targeted inhibition of the classical complement pathway prevents injury in a novel mouse model of acute motor axonal neuropathy[J].Acta Neuropathol Commun,2016,4:23
[18]BAI HX,WANG ZL,TAN LM,et al.The effectiveness of immunomodulating treatment on Miller Fisher syndrome: a retrospective analysis of 65 Chinese patients[J].J Peripher Nerv Syst,2013,18(2):195

相似文献/References:

[1]李 玲),张芳文),王冠男),等.原发睾丸淋巴瘤的临床特点及预后影响因素分析*[J].郑州大学学报(医学版),2017,(04):470.[doi:10.13705/j.issn.1671-6825.2017.04.024]
 LI Ling),ZHANG Fangwen),WANG Guannan),et al.Clinical characteristics and prognosis influnencing factors of primary testicular lymphoma[J].JOURNAL OF ZHENGZHOU UNIVERSITY(MEDICAL SCIENCES),2017,(02):470.[doi:10.13705/j.issn.1671-6825.2017.04.024]
[2]樊冰雨),鲍启德),孙 雷),等.食管癌高、低发区食管鳞癌相关多原发癌的临床特点[J].郑州大学学报(医学版),2019,(02):160.[doi:10.13705/j.issn.1671-6825.2018.12.077]
 FAN Bingyu),BAO Qide),SUN Lei),et al.Clinical characteristics of multiple primary malignancies associated with esophageal squamous carcinoma from high- and low- incidence areas[J].JOURNAL OF ZHENGZHOU UNIVERSITY(MEDICAL SCIENCES),2019,(02):160.[doi:10.13705/j.issn.1671-6825.2018.12.077]
[3]李延娟,张 澍,桑丽娜,等.症状性华氏巨球蛋白血症患者的临床特征及预后影响因素分析[J].郑州大学学报(医学版),2019,(04):627.[doi:10.13705/j.issn.1671-6825.2018.11.056]
 LI Yanjuan,ZHANG Shu,SANG Lina,et al.Clinical features and prognostic factors of patients with symptomatic Waldenstrm's macroglobulinemia[J].JOURNAL OF ZHENGZHOU UNIVERSITY(MEDICAL SCIENCES),2019,(02):627.[doi:10.13705/j.issn.1671-6825.2018.11.056]

备注/Memo

备注/Memo:
【基金项目】国家自然科学基金资助项目(81471545); 河南省自然科学基金资助项目(182300410294); 河南省高等学校重点科研项目(18A360001)
【作者简介】高峰,通信作者,男,1970年12月生,研究员,研究方向:神经免疫病机制与临床,E-mail:gaoyuanshan@126.com; 白宏英,通信作者,女,1964年10月生,教授,主任医师,硕士生研究生导师,研究方向:脑血管病,E-mail:hybai@126.com
更新日期/Last Update: 2019-03-20