Sivadon V, Orlikowski D, Rozenberg F, Quincampoix J-C, Caudie C, Durand M-C, Fauchère J-L, Sharshar T, Raphaël J-C, Gaillard J-L
Laboratoire de microbiologie, hôpital Raymond-Poincaré, AP-HP, 104 boulevard Raymond-Poincaré, 92380 Garches, France.
Pathol Biol (Paris). 2005 Oct-Nov;53(8-9):536-8. doi: 10.1016/j.patbio.2005.06.006. Epub 2005 Aug 3.
We aimed to study prevalence and features of Campylobacter jejuni and cytomegalovirus (CMV)-associated Guillain-Barré syndromes (GBS) in a French care unit.
We studied 264 patients with GBS admitted at Raymond Poincaré hospital (Garches) between 1996 and 2001. Clinical data were obtained prospectively. Sera were collected at patients entry and tested retrospectively for anti-C. jejuni, anti-CMV and antigangliosides GM1 et GM2 antibodies.
GBS associated with a serological evidence for a recent C. jejuni infection were the more frequent (58/264, 22%); they affected predominantly men of mature years (mean age: 51.3 years; sex-ratio M/F: 1.76), mostly after a gastrointestinal illness (52%); they were often pure motor forms (57%), were severe (mechanical ventilation: 40%) and associated to an anti-GM1 IgG and/or IgM response (44%). GBS cases involving a primary CMV infection were less frequent (40/264, 15%), but were severe too (mechanical ventilation: 37.5%); they occurred preferentially in young women (mean age: 35.9 years; sex-ratio MF: 0.82), often after respiratory tract symptoms (28%) or an influenza-like syndrome (15%) and were frequently associated with sensory loss (73%) and with an anti-GM2 IgM response (47%).
C. jejuni and CMV proved to be major triggering agents of GBS in France. They are associated with distinct presentations, which are both severe.
我们旨在研究法国一家护理单位中，空肠弯曲菌和巨细胞病毒（CMV）相关的吉兰-巴雷综合征（GBS）的患病率及特征。
我们研究了1996年至2001年间在雷蒙德·庞加莱医院（加尔什）收治的264例GBS患者。前瞻性地获取临床数据。在患者入院时采集血清，并回顾性检测抗空肠弯曲菌、抗CMV和抗神经节苷脂GM1及GM2抗体。
近期有空肠弯曲菌感染血清学证据的GBS最为常见（58/264，22%）；主要影响成年男性（平均年龄：51.3岁；男女比例：1.76），多数在胃肠道疾病后发病（52%）；常为单纯运动型（57%），病情严重（机械通气：40%），并伴有抗GM1 IgG和/或IgM反应（44%）。原发性CMV感染的GBS病例较少见（40/264，15%），但病情也严重（机械通气：37.5%）；优先发生于年轻女性（平均年龄：35.9岁；男女比例：0.82），常在呼吸道症状后（28%）或类似流感综合征后（15%）发病，常伴有感觉丧失（73%）和抗GM2 IgM反应（47%）。
在法国，空肠弯曲菌和CMV被证明是GBS的主要触发因素。它们与不同的临床表现相关，且病情均较严重。
