GM1-IgM抗体阳性慢性炎性脱髓鞘性多神经病临床、电生理与病理特点  

Clinical,electrophysiological and pathological features of chronic inflammatory demyelinating polyneuropathy with serum GM1-IgM antibodies

作　　者：漆学良[1] 郝洪军[2] 张巍[2] 高枫[2] 袁云[2] 

机构地区：[1]南昌大学第二附属医院神经内科,江西南昌330006 [2]北京大学第一医院神经内科,北京100034

出　　处：《中风与神经疾病杂志》2017年第3期213-216,共4页Journal of Apoplexy and Nervous Diseases

摘　　要：目的探讨GM1-IgM抗体阳性的慢性炎性脱髓鞘性多神经病(chronic inflammatory demyelinating polyneuropathy,CIDP)的临床、电生理和病理改变特点。方法纳入研究的4例患者,分别为2例男性和2例女性,发病年龄在12~64岁之间,发病到就诊时间在6 m^2 y之间,3例出现非对称性下肢无力,1例表现为单侧上肢和对侧下肢无力。对4例患者进行血和脑脊液的GM1-IgM和IgG抗体检查,进行神经电生理检查和腓肠神经活检。结果 4例均出现血清GM1-IgM抗体阳性,电生理检查提示多个感觉神经和运动神经传导速度减慢和诱发电位波幅降低,1例出现神经传导阻滞现象。病理检查发现腓肠神经的轻度有髓神经纤维轴索变性和髓鞘脱失。结论GM1-IgM抗体阳性CIDP多表现为以下肢无力为主的非对称性神经病。Objective To explore the clinical,electrophysiological and pathological features in 4 cases of chronic inflammatory demyelinating polyneuropathy with GM1-IgM antibodies. Methods The patients were 2 men and 2 women whose ages ranged from 12 to 64 years. The duration from onset of disease to diagnostic time ranged from 6 months to 2years. 3 of them mainly presented with asymmetric distal muscle weakness of lower limbs,one presented crossed limb weakness. All patients showed GM1-IgM antibodies positive in serum and negative in the CSF. The CSF proteins were within normal limit. Nerve conduction velocities and sural nerve biopsy were performed in all 4 cases. Result All patients had decreased motor and sensory nerve conduction velocities as well as amplitude of compound muscle action potentials. One case showed motor conduction blocked. Mild axonal degeneration,regeneration and demyelination appeared in the sural nerve. Conclusions GM1-IgM antibodies positive chronic inflammatory demyelinating polyneuropathy usually presented asymmetric motor neuropathies of lower limbs.

关 键 词：慢性炎性脱髓鞘性多神经病 GM-1抗体 多灶性获得性脱髓鞘性感觉运动神经病 多灶性运动神经病 

分 类 号：R744[医药卫生—神经病学与精神病学]