吉兰-巴雷综合征实验室检测指标诊断价值分析  

Analysis for diagnostic value of laboratory indicators inGuillain-Barre syndrome

作　　者：郑雪雯 徐士兰 刘国烨 周万青[1] ZHENG Xuewen;XU Shilan;LIU Guoye;ZHOU Wanqing(Department of Laboratory Medicine,Nanjing Drum Tower Hospital,Affiliated Hospital of Medical School,Nanjing University,Nanjing 210008,Jiangsu,China)

机构地区：[1]南京大学医学院附属鼓楼医院检验科,南京210008

出　　处：《临床检验杂志》2025年第2期102-105,共4页Chinese Journal of Clinical Laboratory Science

摘　　要：目的 探讨脑脊液蛋白质-细胞分离现象、脑脊液免疫球蛋白G(CSF-IgG)、脑脊液白蛋白(CSF-ALB)、血清免疫球蛋白G(S-IgG)单项及联合检测在吉兰-巴雷综合征(GBS)诊断中的价值。方法 回顾性分析65例GBS患者(GBS组)和65例非GBS的其他神经系统疾病患者(非GBS组)的临床资料。收集2组患者脑脊液和血清标本,统计分析脑脊液蛋白质-细胞分离现象、CSF-IgG、CSF-ALB、S-IgG单项及联合检测诊断GBS的效能。结果 60.00%(39/65)GBS患者存在脑脊液蛋白质-细胞分离现象;67.69%(44/65)GBS患者发病前有前驱事件,主要为上呼吸道感染43.08%(28/65)、消化道感染9.23%(6/65)、疱疹病毒感染7.69%(5/65)。GBS组CSF-IgG、CSF-ALB、S-IgG水平均高于非GBS组,差异有统计学意义(P<0.05)。CSF-IgG、CSF-ALB、S-IgG和脑脊液蛋白质-细胞分离现象单项以及四者联合检测诊断GBS对应的ROC曲线下面积(AUCROC)分别为0.754、0.705、0.682、0.708和0.840,诊断特异性分别为87.7%、75.4%、87.7%、81.5%和96.9%。结论 大部分GBS患者存在脑脊液蛋白质-细胞分离现象与前驱感染史。CSF-IgG、CSF-ALB、S-IgG和脑脊液蛋白质-细胞分离现象具有一定的独立诊断效能,将四者联合检测,有利于提高对GBS的诊断能力。Objective To explore the diagnostic value of the phenomenon of protein-cell separation in cerebrospinal fluid(CSF),as well as the single and combined detections of CSF immunoglobulin G(CSF-IgG),CSF albumin(CSF-ALB)and serum immunoglobulin G(S-IgG)for Guillain-Barre syndrome(GBS).Methods A retrospective analysis was conducted on the clinical data of 65 GBS patients(GBS group)and 65 patients with other neurological diseases(non-GBS group).CSF and serum samples were collected from both the groups to analyze the diagnostic efficacy of protein-cell separation phenomenon in CSF,as well as the single and combined detections of CSF-IgG,CSF-ALB,and serum-IgG(S-IgG)in GBS.Results CSF protein-cell separation phenomenon was observed in 60.00%(39/65)of GBS patients.Prodromal events were presented in 67.69%(44/65)of GBS patients,which mainly were upper respiratory tract infection(43.08%,28/65),digestive tract infection(9.23%,6/65),and herpetic virus infection(7.69%,5/65).The levels of CSF-IgG,CSF-ALB,and S-IgG in the GBS group were significantly higher than those in non-GBS group(P<0.05).The areas under the ROC curves(AUC^(ROC))for single CSF-IgG,CSF-ALB,S-IgG,protein-cell separation phenomenon IN CSF,and the combination of all the four parameters in diagnosis of GBS were 0.754,0.705,0.682,0.708,and 0.840,respectively.The diagnostic specificities were 87.7%,75.4%,87.7%,81.5%,and 96.9%,respectively.Conclusion Most of the GBS patients were found to have CSF protein-cell separation phenomenon and history of prodromal infection.CSF-IgG,CSF-ALB,S-IgG,and CSF protein-cell separation phenomenon exhibited independent diagnostic value for GBS.The combined detection of the four indicators could improve the diagnostic efficacy for GBS.

关 键 词：吉兰-巴雷综合征 脑脊液蛋白质-细胞分离现象 脑脊液免疫球蛋白G 脑脊液白蛋白 血清免疫球蛋白G 

分 类 号：R446.1[医药卫生—诊断学]