吉兰-巴雷综合征患者抗GM1抗体与抗甲状腺抗体相关性研究
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南京鼓楼医院神经内科

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国家自然科学基金(编号:82271335);江苏省自然科学基金(编号:BK20221170)


Correlation between anti-GM1 antibody and anti-thyroid antibody in Guillain-Barre syndrome patients
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    摘要:

    目的:抗神经节苷脂抗体(Antiganglioside antibodies,AGAs)在吉兰-巴雷综合征(Guillain–Barré syndrome,GBS)发病机制中扮演重要角色。本研究旨在探讨GBS患者抗甲状腺抗体与AGAs之间的关联。方法:我们选取了2018年7月至2023年2月南京鼓楼医院收治的同时检测了抗甲状腺抗体和AGAs水平的60例GBS患者,根据抗甲状腺抗体结果将患者分为正常组和异常组,比较两组患者的临床特征、甲状腺功能以及AGAs比例。结果:与正常组相比,甲状腺功能异常组中GBS患者出现明显升高的抗神经节苷酯GM1抗体(p<0.05)和GM2抗体(p<0.05),并伴有更严重的临床症状(p<0.05)。多因素logistic回归分析显示,对于GBS患者而言,存在抗甲状腺抗体异常(OR=5.184, 95%CI [1.377,19.518],p=0.015)以及游离甲状腺素(FT4)水平升高 (OR=1.266, 95%CI [1.009,1.588],p=0.030),是导致抗GM1抗体阳性率增加的独立危险因素。ROC曲线分析发现TPO-Ab预测GM1阳性时最佳阈值为47.9 IU/mL,灵敏度为66 .7%,特异度为77 .8%。Tg-Ab预测GM1阳性时最佳阈值为20.0 IU/mL,灵敏度为73.3%,特异度为73 .3%。结论:合并抗甲状腺抗体异常的GBS患者更易出现抗GM1抗体阳性,这可能是合并甲状腺功能异常的GBS患者预后更差的可能机制。

    Abstract:

    Objective: Antiganglioside antibodies (AGAs) play a crucial role in the pathogenesis of Guillain–Barré syndrome (GBS). We aim to explore the relationship between thyroid autoantibodies and AGAs in GBS patients. Methods: We selected 60 GBS patients who were admitted to Nanjing Drum Tower Hospital from July 2018 to February 2023 and tested for both anti-thyroid antibodies and AGAs levels. According to anti-thyroid antibodies, the patients were divided into normal group and abnormal group. The clinical characteristics, thyroid function and the proportion of AGAs in the two groups were compared. Results: Compared with the normal group, GBS patients in the abnormal group had significantly increased anti-GM1 antibodies (p<0.05) and anti-GM2 antibodies (p<0.05), and were accompanied by more severe clinical symptoms (p<0.05). Multivariate logistic regression analysis showed that the presence of abnormal anti-thyroid antibodies (OR=5.184, 95%CI [1.377, 19.518], p=0.015) and increased free thyroxine (FT4) levels (OR=1.266, 95%CI [1.009, 1.588], p=0.030) were independent risk factors for increased anti-GM1 antibody positive rate in GBS patients. ROC curve analysis found that the optimal threshold for TPO-Ab to predict anti-GM1 Ab positive was 47.9 IU/mL, with a sensitivity of 66.7% and a specificity of 77.8%. The optimal threshold for Tg-Ab to predict anti-GM1 Ab positive was 20.0 IU/mL, with a sensitivity of 73.3% and a specificity of 73.3%. Conclusion: Our results suggest an association between thyroid autoantibodies and anti-GM1 antibody in GBS patients, potentially explaining the poorer prognosis of GBS patients with thyroid dysfunction.

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  • 收稿日期:2023-12-31
  • 最后修改日期:2024-01-12
  • 录用日期:2024-02-26
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