Department of Neurology, Heinrich-Heine-University, Moorenstrasse 5, Düsseldorf, Germany.
Lancet Infect Dis. 2010 Sep;10(9):643-51. doi: 10.1016/S1473-3099(10)70140-7.
Guillain-Barré syndrome (GBS) is an acute, acquired, monophasic autoimmune disorder of peripheral nerves that develops in susceptible individuals after infection and, in rare cases, after immunisation. Exposure to influenza via infection or vaccination has been associated with GBS. We review the relation between GBS and these routes of exposure. Epidemiological studies have shown that, except for the 1976 US national immunisation programme against swine-origin influenza A H1N1 subtype A/NJ/76, influenza vaccine has probably not caused GBS or, if it has, rates have been extremely low (less than one case per million vaccine recipients). By contrast, influenza-like illnesses seem to be relevant triggering events for GBS. The concerns about the risk of inducing GBS in mass immunisation programmes against H1N1 2009 do not, therefore, seem justified by the available epidemiological data. However, the experiences from the 1976 swine flu vaccination programme emphasise the importance for active and passive surveillance to monitor vaccine safety.
格林-巴利综合征（GBS）是一种急性、获得性、单相自身免疫性周围神经病，易患人群在感染后（极少数情况下在免疫接种后）发病。感染流感或接种流感疫苗与 GBS 有关。我们回顾了 GBS 与这些暴露途径之间的关系。流行病学研究表明，除了 1976 年美国针对猪源甲型 H1N1 亚型 A/NJ/76 的全国免疫接种计划外，流感疫苗可能不会导致 GBS，或者如果导致，发病率极低（每百万疫苗接种者不到一例）。相比之下，流感样疾病似乎是 GBS 的相关触发事件。因此，针对 2009 年 H1N1 大流行进行大规模免疫接种计划引起 GBS 的担忧，似乎没有得到现有流行病学数据的支持。然而，1976 年猪流感疫苗接种计划的经验强调了积极和被动监测以监测疫苗安全性的重要性。
