肝病合并格林-巴利综合征七例临床分析及文献复习  

Clinical analysis on 7 cases with liver diseases complicated by Guillain-Barre syndrome and related literature review

作　　者：程丹颖[1] 王笑梅[1] 欧蔚妮[1] 段英[1] 赵莹莹[1] 邢卉春[1] 

机构地区：[1]首都医科大学附属北京地坛医院肝病中心,北京100015

出　　处：《中华实验和临床感染病杂志（电子版）》2014年第3期78-81,共4页Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)

摘　　要：目的分析肝病合并格林-巴利综合征(GBS)患者的临床特点,探讨肝病与GBS之间的相互关系,总结治疗经验。方法回顾性分析本院1996年至2013年收治的7例肝病合并GBS患者的临床资料,分析肝病患者发生GBS的相关危险因素。结果 7例患者中病毒性肝炎合并GBS者5例,酒精性肝病合并GBS者2例。表现为双下肢无力者7例,双上肢无力者5例,肢体麻木者6例,肢体疼痛者2例,颅神经受损者4例,呼吸肌麻痹者1例。感染病毒的种类及转氨酶、胆红素升高的程度与神经系统症状轻重无关。急性戊型病毒性肝炎合并GBS时更易出现颅神经受损。5例患者进行了腰椎穿刺检查,均表现为蛋白-细胞分离。5例患者行肌电图检查,均提示为周围神经源性损害。及时接受丙种球蛋白治疗的5例患者恢复良好。结论 GBS可能与肝炎病毒感染有关。肝病合并GBS临床表现复杂多样,早期确诊、尽早治疗,及时接受丙种球蛋白治疗的患者预后良好。Objective To analyze the clinical characteristics of patients with liver diseases complicated by Guillain-Barre syndrome （GBS）, investigate the relationship between liver diseases and GBS, summarize the treatment experience.Methods The clinical data of 7 cases of liver diseases with GBS in our hospital from 1996 to 2013 were analyzed, retrospectively, and the risk factors of GBS in patients with liver diseases were explored, respectively.Results Total of 7 cases which included 5 male and 2 female with the average age of （45.14±14.35） years old in our study. There were 5 cases were viral hepatitis with GBS and 2 cases were alcoholic liver diseases with GBS. Performance for the weakness of lower limbs in 7 cases, upper limbs weakness in 5 cases, 6 cases of sensory disturbance, 2 cases of limb pain, 4 cases of cranial nerve palsy, 1 case of ventilator. There was no connection between the kind of virus, the level of transaminase and bilirubin and the severity of neurological symptoms. Acute viral hepatitis E in patients with GBS were more prone to injury the cranial nerve. There were 5 patients underwent lumbar puncture and examination of cerebrospinal lfuid which showed separation of protein and cell. There were 5 patients underwent electromyography which showed peripheral neurogenic damage. There were 5 patients recovered from the neurological manifestations perfectly who treated with gamma globulin promptly.Conclusions The pathogenesis of GBS may be related with infection of hepatitis virus. The clinical manifestations of patients with liver diseases complicated by GBS is various and complicated. Patients who diagnosed and treated with gamma globulin timely have a favorable prognosis.

关 键 词：病毒性肝炎 酒精性肝病 格林-巴利综合征 

分 类 号：R575[医药卫生—消化系统] R745.13[医药卫生—内科学]