付佩彩.45例抗GQ1b抗体阳性患者临床疾病谱[J].内科急危重症杂志,2022,28(3):191-195
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| DOI：10.11768/nkjwzzzz20220304 |
| 中文关键词: 抗GQ1b 抗体 抗GQ1b抗体综合征 Miller-Fisher综合征 临床疾病谱 |
| 英文关键词: |
| 基金项目:湖北省自然科学基金 (No:2020CFB744)，湖北省卫生健康委员会科研项目(No:WJ2021M119） |
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| 中文摘要: |
| 目的：分析具有不同临床特征的抗GQ1b抗体阳性患者的临床疾病谱。方法：回顾性分析45例抗GQ1b抗体阳性患者的临床症状、体征、辅助检查、治疗及预后等临床资料。结果：45例（男24，女21）抗GQ1b抗体阳性患者中，抗GQ1b抗体综合征32例，抗GQ1b抗体阳性吉兰巴雷综合征（GBS）10例，抗GQ1b抗体阳性慢性炎症性脱髓鞘性多发性神经病（CIDP）3例。平均年龄（49.8 ±11.5）岁。血清抗GQ1b-IgG阳性40 例，抗GQ1b-IgM阳性5例，神经节苷脂抗体重叠阳性19例。抗GQ1b抗体综合征分为：经典型Miller-Fisher 综合征（MFS）12例（43.8%），Bickerstaff脑干脑炎（BBE）3例（9.4%），伴有眼肌麻痹的GBS 5例（15.6%），不完全形式的MFS 12例 [（43.8%，包括无共济失调的急性眼轻瘫（AO）8例，急性瞳孔扩大2例，急性球麻痹1例，急性前庭综合征1例)]。10例抗GQ1b抗体阳性GBS与抗体阴性的GBS在临床经过及症状体征方面比较，差异无统计学意义（P均＞0.05），3例抗GQ1b抗体阳性CIDP中，抗GQ1b-IgM阳性2例，临床表现为经典CIDP。结论：抗GQ1b抗体综合征是一组血清抗GQ1b抗体阳性、临床表现多样的自身免疫性疾病连续谱。 |
| 英文摘要: |
| Objective: To investigate the clinical spectrum of 45 patients with positive serum anti-GQ1b antibodies. Methods: The clinical data including the clinical symptoms, physical examination signs, adjuvant examinations, treatment, and prognosis of 45 patients with positive anti-GQ1b antibodies were retrospectively analyzed. Results: Of the 45 patients with positive serum anti-GQ1b antibodies, there were 32 cases of anti-GQ1b antibodies syndrome, 10 cases of Guillain-Barre syndrome (GBS) and 3 cases of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). A total of 24 cases were male and 21 cases were female. The average age was (49.78±11.49) years old. The IgG-anti-GQ1b antibody in serum was positive in 40 patients, while the IgM-anti-GQ1b antibody was positive in 5 patients. A total of 19 of 45 patients were positive for other anti-ganglioside antibodies at the same time. The anti-GQ1b antibodies syndrome was comprised of 12(43.8%) of classical Miller Fisher syndrome (MFS), 3(9.4%) of Bickerstaff brainstem encephalitis (BBE), 5(15.6%) of GBS with ophthalmoplegia, and 12(43.8%) of incomplete forms of MFS which including 8 cases of acute ophthalmoparesis (AO), 2 cases of acute mydriasis, 1 case of acute oropharyngeal palsy, 1 case of acute vestibular syndrome. There was no statistically significant difference between the 10 cases of positive anti-GQ1b antibody GBS and negative-antibody GBS in clinical course and characteristics. A total of 3 cases of positive anti-GQ1b antibody CIDP clinically presented as classical CIDP. 〖JP2〗Conclusions: The anti-GQ1b antibodies syndrome is a serial of clinical disease spectrum, characterizing as positive serum anti-GQ1b antibodies and diverse clinical symptom involving with peripheral and central nerve systems respectively or simultaneously. |
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