吉兰-巴雷综合征的研究进展

吉兰-巴雷综合征是一种由于感染等原因所致的自身免疫性多发性神经疾病,主要的感染菌为空肠弯曲杆菌。男性患者多于女性。目前临床较为支持的发病机制为分子模拟理论,临床最主要的两大分类是轴索型及脱髓鞘型。欧美等国家以脱髓鞘型为主,亚洲国家以轴索型为主。另外还有一些在吉兰-巴雷综合征中所占比例较低的临床特殊分型,如:Miller Fisher综合征和咽-颈-臂变异型。吉兰-巴雷综合征最有效的治疗方法为静滴丙种球蛋白与血浆置换,且这两种方法的有效性已有循证医学证据支持。激素治疗目前循证医学证据提示无效,基础支持疗法不可轻视。大部分吉兰-巴雷综合征患者为单相病程,仅极少部分患者可复发。Miller Fisher综合征临床预后较好,高龄、轴索型等预后较差。

Advances in Guillain-Barre Syndrome

Guillain-Barre syndrome is a result of infection and other causes of autoimmune disease polyneuropathy, is the most infective strain. Male patients are more than female. The most supported clinical pathogenesis is molecular simulation theory. The two most important clinical classification are axonal and demyelinating types. Demyelinating type was mainly in Europe and America, while axonal type was mainly in Asian. Miller Fisher syndrome and Pharyngeal-cervical-brachial variant are two special types which were rare in Clinical. The most effective treatment methods are intravenous immune globulin therapy and plasmapheresis which have been supported by evidence-based medicine. Hormone therapy was considered invalid currently by evidence based medicine, but basic supportive therapy should not be underestimated. Most patients were single-phase duration, only a few patients could relapse. Prognosis in Miller Fisher syndrome is good while poor in old and acute motor axonal neuropathy patients.