Talukder R K, Sutradhar S R, Rahman K M, Uddin M J, Akhter H
Mymensingh Medical College, Mymensingh, Bangladesh.
Mymensingh Med J. 2011 Oct;20(4):748-56.
Guillian-Barre syndrome (GBS) is the most common cause of acute flaccid paralysis. All age groups can be affected, more common in elderly. Campylobacter jejuni, a major cause of bacterial gastroenteritis worldwide has become recognized as a most frequent antecedent pathogen for GBS. A prospective case-controlled study showed, positive C. Jejuni serology was found in an unprecedented high frequency of 57% as compared to 8% in family controls and 3% in control patients with other neurological diseases. In GBS there is molecular mimicry between epitops found in the cell walls of some micro-organisms and gangliosides in schwann cell membrane. Diagnosis is mainly clinical. The mainstay of treatment of GBS is supportive care and prevention of complications. Respiratory failure and autonomic dysfunction are the common causes of death from GBS. Plasma exchange and intravenous immunoglobulin therapy shorten the duration of ventilation and improve prognosis. Overall, prognosis of GBS is good. Eighty percent of patients recover completely within 3-6 months, 4% die, and the remainder suffers residual neurological disability. GBS may be prevented by development of a vaccine against C. Jejuni. Early and specific diagnosis is important to ensure a favourable outcome.
吉兰-巴雷综合征（GBS）是急性弛缓性麻痹最常见的病因。各年龄组均可受累，在老年人中更为常见。空肠弯曲菌是全球细菌性胃肠炎的主要病因，现已被公认为GBS最常见的前驱病原体。一项前瞻性病例对照研究表明，GBS患者空肠弯曲菌血清学检测呈阳性的频率高达57%，前所未有的高，而家庭对照组为8%，其他神经系统疾病对照患者为3%。在GBS中，某些微生物细胞壁中的表位与施万细胞膜中的神经节苷脂之间存在分子模拟。诊断主要依靠临床。GBS治疗的主要方法是支持治疗和预防并发症。呼吸衰竭和自主神经功能障碍是GBS致死的常见原因。血浆置换和静脉注射免疫球蛋白治疗可缩短通气时间并改善预后。总体而言，GBS的预后良好。80%的患者在3至6个月内完全康复，4%死亡，其余患者有残留神经功能障碍。针对空肠弯曲菌开发疫苗可能预防GBS。早期和特异性诊断对于确保良好预后很重要。
