Sater R A, Rostami A
Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia 19104, USA.
Neurology. 1998 Dec;51(6 Suppl 5):S9-15. doi: 10.1212/wnl.51.6_suppl_5.s9.
Guillain-Barré syndrome (GBS) is an acute polyneuropathy that typically presents as a progressive flaccid paralysis. The pathology is believed to be caused by both cellular and humoral immune processes. This inflammatory neuropathy has a mortality rate of 4-5%. About 30% of patients require mechanical ventilation, and these patients are often hospitalized for months before regaining the ability to walk. Immunomodulation is used to improve the recovery rate and shorten hospital stays. Plasma exchange was shown to be effective in improving recovery time in GBS in several controlled trials during the 1980s. In this decade, intravenous immunoglobulin (IVIg) therapy has been shown to be equally effective for therapy of GBS and its variants. Although the precise mechanisms of immunomodulation by IVIg are unknown, it probably directly inactivates specific anti-myelin antibodies and indirectly inhibits their production. IVIg offers some advantages over plasma exchange by being better tolerated in some patients and being easily administered without special equipment. However, because of the possibility of progression, the treatment of GBS patients requires qualified neurologic and supportive care.
格林-巴利综合征（GBS）是一种急性多发性神经病，通常表现为进行性弛缓性麻痹。其病理被认为是由细胞免疫和体液免疫过程共同引起的。这种炎性神经病的死亡率为4%至5%。约30%的患者需要机械通气，这些患者在恢复行走能力之前通常要住院数月。免疫调节用于提高恢复率并缩短住院时间。在20世纪80年代的几项对照试验中，血浆置换被证明可有效缩短GBS患者的恢复时间。在这十年中，静脉注射免疫球蛋白（IVIg）疗法已被证明对GBS及其变体的治疗同样有效。尽管IVIg免疫调节的确切机制尚不清楚，但它可能直接使特定的抗髓鞘抗体失活并间接抑制其产生。IVIg比血浆置换具有一些优势，因为它在一些患者中耐受性更好，且无需特殊设备即可轻松给药。然而，由于病情可能进展，GBS患者的治疗需要合格的神经科和支持性护理。
