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目的探讨急性Ｇｕｉｌａｉｎ－Ｂａｒｅ综合征（ＧＢＳ）的免疫学改变及其与临床的关系。方法测定２１例急性期ＧＢＳ患者和１６例正常人血清及外周血单个核细胞（ＰＢＭＣ）上清液ＩＬ－２、ＩＬ－６、ＴＮＦ－α、免疫球蛋白及血清Ｔ细胞亚群。结果ＧＢＳ患者血清ＩＬ－２、ＴＮＦ－α，ＰＢＭＣ上清液ＩＬ－２、ＩＬ－６、ＴＮＦ－α和ＩｇＧ都高于正常对照组（Ｐ＜０．０５或０．０１）；１４例患者有一种以上血清免疫球蛋白或ＩｇＧ亚类增高；与对照组比较，患者ＣＤ３、ＣＤ４无异常，ＣＤ８降低（Ｐ＜０．０１），致ＣＤ４／ＣＤ８比值升高（Ｐ＜０．０１）。重型组ＰＢＭＣ上清液ＴＮＦ－α高于轻型组（Ｐ＜０．０５）。结论ＧＢＳ患者存在Ｔ细胞功能紊乱和Ｂ细胞多克隆活化，ＩＬ－２、免疫球蛋白、尤其ＴＮＦ－α异常在ＧＢＳ发病中起重要作用。
Objective To investigate the immunological changes of acute Guilain-Bare syndrome (GBS) and their clinical significance. Methods Serum and peripheral blood mononuclear cells (PBMC) supernatant IL-2, IL-6, TNF-α, immunoglobulin and serum T cell subsets of 21 acute GBS patients and 16 normal subjects were determined. Results Serum levels of IL-2, TNF-α, IL-2, IL-6, TNF-α and IgG in serum of GBS patients were significantly higher than those of normal controls (P <0.05 or 0.01) There was more than one serum immunoglobulin or IgG subclass. Compared with the control group, there was no abnormality of CD3 and CD4 and CD8 (P <0.01), and the ratio of CD4 / CD8 increased (P <0.01). The level of TNF-α in the supernatant of PBMC in the severe group was higher than that in the light group (P <0.05). Conclusions T cell dysfunction and polyclonal activation of B cells exist in patients with GBS. The abnormalities of IL-2, immunoglobulin, especially TNF-α play an important role in the pathogenesis of GBS.