Tsukada N, Koh C S, Inoue A, Yanagisawa N
J Neurol Sci. 1987 Feb;77(2-3):203-16. doi: 10.1016/0022-510x(87)90123-7.
We observed 4 patients with the Guillain-Barré syndrome (GBS) type of polyneuropathy and one patient with chronic relapsing polyneuropathy associated with hepatitis B virus infection, and examined the sera, cerebrospinal fluid (CSF) and sural nerve specimens from the patients in search of the pathogenetic factors involved. It was demonstrated that hepatitis B surface antigen(HBsAg)-immune complexes were significantly increased in both the sera and the CSF of the 4 patients with GBS. The serum levels of immune complexes were also closely related to the clinical status of these patients. In all patients, HBsAg-positive labelling of immunofluorescence was found around the endoneural small blood vessels and in the endoneurium. Electron-dense deposits, suggestive of immune complexes composed of hepatitis B virus, were demonstrated in the endoneurium of the patient with chronic relapsing polyneuropathy. These results suggest that HBsAg immune complexes may be of importance in the etiology of GBS or chronic relapsing polyneuropathy associated with hepatitis B virus infection.
我们观察了4例患有格林-巴利综合征（GBS）型多发性神经病的患者以及1例与乙型肝炎病毒感染相关的慢性复发性多发性神经病患者，并检测了这些患者的血清、脑脊液（CSF）和腓肠神经标本，以寻找其中涉及的致病因素。结果表明，4例GBS患者的血清和脑脊液中乙型肝炎表面抗原（HBsAg）免疫复合物均显著增加。免疫复合物的血清水平也与这些患者的临床状况密切相关。在所有患者中，在内神经小血管周围和神经内膜中均发现了免疫荧光的HBsAg阳性标记。在慢性复发性多发性神经病患者的神经内膜中发现了电子致密沉积物，提示由乙型肝炎病毒组成的免疫复合物。这些结果表明，HBsAg免疫复合物可能在GBS或与乙型肝炎病毒感染相关的慢性复发性多发性神经病的病因学中具有重要意义。
