Page 70 - 南京医科大学学报自然科学版

南京医科大学学报（自然科学版） 第44卷第3期
·360 · Journal of Nanjing Medical University（Natural Sciences） 2024年3月

·临床研究·

吉兰⁃巴雷综合征患者抗GM1抗体与抗甲状腺抗体的相关性研究

詹 慧，常蕾蕾，孟海兰，陈燕婷，陈 妍 *
南京大学医学院附属南京鼓楼医院神经内科，江苏 南京 210008

［摘 要］ 目的：探讨吉兰⁃巴雷综合征（Guillain⁃Barré syndrome，GBS）患者抗甲状腺抗体与抗神经节苷脂 GM1 抗体的相关
性。方法：收集2018年7月—2023年2月南京大学医学院附属鼓楼医院神经内科收治的同时检测抗甲状腺抗体和抗神经节苷
脂抗体（antiganglioside antibody，AGA）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 AGA 比例。结果：与正常组相比，甲状腺功能异常组中 GBS 患者抗神经节苷酯 GM1 抗体和
GM2抗体水平人明显升高，并伴有更严重的临床症状（P < 0.05）。多因素Logistic回归分析显示，GBS患者抗甲状腺抗体异常
（OR=5.184，95%CI：1.377~19.518，P=0.015）以及游离甲状腺素（free thyroxine，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。受试者工作特征（receiver operation characteristic，ROC）曲线显示
甲状腺过氧化物酶抗体（thyroperoxidase antibody，TPO⁃Ab）预测GM1阳性的最佳阈值为47.9 U/mL，灵敏度为66.7%，特异度为
77 .8%。甲状腺球蛋白抗体（thyroglobulin antibody，Tg⁃Ab）预测GM1阳性的最佳阈值为20.0 U/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。
［关键词］ 吉兰⁃巴雷综合征；抗神经节苷脂抗体；抗神经节苷脂GM1抗体；甲状腺过氧化物酶抗体；甲状腺球蛋白抗体
［中图分类号］ R745 ［文献标志码］ A ［文章编号］ 1007⁃4368（2024）03⁃360⁃07
doi：10.7655/NYDXBNSN231225

Correlation between anti ⁃ GM1 antibody and anti ⁃ thyroid antibody in Guillain ⁃ Barré
syndrome patients

ZHAN Hui，CHANG Leilei，MENG Hailan，CHEN Yanting，CHEN Yan *
Department of Neurology，Nanjing Drum Tower Hospital，the Affiliated Hospital of Medical School，Nanjing
University，Nanjing 210008，China

［Abstract］ Objective：We aimed to explore the relationship between thyroid autoantibodies and anti⁃GM1 antibody in Guillain⁃
Barré syndrome（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 Antiganglioside antibody（AGA）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 AGA in the two groups were compared. Results：Compared with the normal group，GBS patients in the abnormal
group had significantly increased anti⁃GM1 antibody（Ab）（P < 0.05）and anti⁃GM2 Ab（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. Receiver operation
characteristic（ROC）curve analysis found that the optimal threshold for thyroperoxidase antibody（TPO⁃Ab）to predict anti⁃GM1 Ab
positive was 47.9 U/mL，with a sensitivity of 66.7% and a specificity of 77.8%. The optimal threshold for thyroglobulin antibody（Tg⁃Ab）
to predict anti⁃GM1 Ab positive was 20.0 U/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.

［基金项目］ 国家自然科学基金（82271335）；江苏省自然科学基金（BK20221170）
∗
通信作者（Corresponding author），E⁃mail：chenyan20141014@163.com