吉兰-巴雷综合征急性期湿热证与体液免疫的关系_临床医学论文.docVIP

吉兰-巴雷综合征急性期湿热证与体液免疫的关系_临床医学论文 吉兰-巴雷综合征急性期湿热证与体液免疫的关系_临床医学论文 作者：贲莹 高长玉 刘桂宇 王彩娟 【摘要】 　　目的 探讨吉兰-巴雷综合征（GBS）急性期湿热证与体液免疫的关系。方法 对GBS患者进行中医辨证，分为湿热证组20例和非湿热证组14例。对2组分别进行免疫球蛋白（Ig)G、A、M检测，并与正常对照组进行比较。结果 GBS急性期湿热证组IgG含量高于非湿热证组和正常对照组（P＜0.05）；IgA含量高于正常对照组（P＜0.05），但与非湿热证组比较差异无统计学意义；IgM含量与非湿热证组和正常对照组比较差异均无统计学意义（P＞0.05）。结论 GBS急性期湿热证表现为较强烈的体液免疫炎症反应。IgG、IgA含量增高。免疫球蛋白的变化可作为GBS湿热证辨证的微观参考指标。 【关键词】 多发性神经根神经病; 免疫球蛋白A; 免疫球蛋白G; 免疫球蛋白M; 湿热 　　Relation of syndrome of damp-heat of acute period of GBS with humoral immunity 　　【Abstract】 Objective To discuss the relation of syndrome of damp-heat of acute period of GBS with humoral immunity. Methods 34 patients with GBS were divided into two groups (damp-heat syndrome group, nondamp-heat syndrome group) by differentiated syndromes of TCM. The level of immunoglobulin (IgG、IgA、IgM) were detected in this two groups and normal control group These data were compared with normal control group. Results The level of IgG of damp-heat syndrome group was higher than nondamp-heat syndrome group and normal control group (0.05). The level of IgA of damp-heat syndrome group was higher than normal control group (0.05). But comparing with nondamp-heat syndrome group, there was not obvious difference (Pgt;0.05). Comparing the level of IgM of damp-heat syndrome group with nondamp-heat syndrome group and normal control group, there was not obvious difference (Pgt;0.05). Conclusion The syndrome of damp-heat of acute period of GBS manifested intense humoral immunity. It shows the level of IgG、IgA、increase. Immunoglobulin can be made guideline of syndrome of damp-heat. 　　【Key words】 Guillain-Barre syndrome; Immunoglobulin A; Immunoglobulin G; Immunoglobulin M; Syndrome of damp-heat 　　吉兰-巴雷综合征（guillain-barre syndrome, GBS）是由于非特异性感染所引起的自身免疫性多发性周围神经病。临床主要表现为四肢对称性迟缓性瘫痪，部分患者有颅神经损害和感觉障碍，严重者合并呼吸肌麻痹。GBS发病的确切机制不明，有多种学说，其中分子模拟学说被多数学者所认同。该学说认为是由于病原体某些组分与周围神经组分相似，机体发生交叉免疫，引起周围神经脱髓鞘。目前研究发现GBS患者白细胞介素-2（IL-2）、肿瘤坏死因子-α（TNF-α）等免疫介质增高，T细胞亚群和免疫球蛋白含量异常，说明其免疫系统功能失常［1］。依据其临床表现应属于中医痿证范畴。痿证一