Neurology:骨科和消化科手术与GBS相关性强大

2018-10-15 杨中华 脑血管病及重症文献导读

格林巴利综合征(GBS)常发生于胃肠道和呼吸道感染以后。基于大量病例报道,有人怀疑外科手术也是CBS的触发因素。

格林巴利综合征(GBS)常发生于肠道和呼吸道感染以后。基于大量病例报道,有人怀疑外科手术也是CBS的触发因素。按照一小部分已经发表的回顾性病例总结的数据,5-19%的GBS患者发病6周或8周内进行过外科手术,这个数据提示外科手术后GBS的发生率高于一般人群。外科手术后发生GBS的机制有几种。比如外科手术会改变免疫系统的平衡,引起短暂免疫抑制,这会导致自身抗体攻击周围神经。也有人认为这种免疫抑制会增加亚临床感染的机会,后者会诱发GBS。外科手术中会释放抗原,随后对这些抗原产生自身免疫反应,这也可能是GBS的机制。

2018年9月来自法国的J'er'emie Rudant等在Neurology上公布了他们的基于人群(法国国家健康管理数据库,French nationwide health administrative databases)的流行病学研究,以评价GBS和近期外科手术的关系。

在这个大型国家流行病学研究中,研究者最终发现GBS与所有类型近期外科手术轻度相关(moderately),与骨科和消化器官外科手术相关性更强。

原始出处:Rudant J1, Dupont A2, Mikaeloff Y2, et al. Surgery and risk of Guillain-Barré syndrome: A French nationwide epidemiologic study. Neurology. 2018 Sep 25;91(13):e1220-e1227. 

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    2019-08-06 一叶知秋
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    2019-01-12 yinhl1978
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  5. 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topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Mon Oct 15 07:41:07 CST 2018, time=2018-10-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=349389, encodeId=8b13349389b6, content=学习了长知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Mon Oct 15 07:41:03 CST 2018, time=2018-10-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=349388, encodeId=85c134938876, content=学习了长知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Mon Oct 15 07:40:57 CST 2018, time=2018-10-15, status=1, ipAttribution=)]
    2018-10-16 明月清辉

    谢谢分享,学习了

    0

  6. 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likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Mon Oct 15 07:40:57 CST 2018, time=2018-10-15, status=1, ipAttribution=)]
    2018-10-15 flysky120

    学习一下知识谢谢

    0

  7. 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likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Mon Oct 15 07:40:57 CST 2018, time=2018-10-15, status=1, ipAttribution=)]
    2018-10-15 Y—xianghai

    学习了长知识

    0

  8. 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topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160718/IMG578C993D395567540.jpg, createdBy=59b81918946, createdName=flysky120, createdTime=Mon Oct 15 09:53:36 CST 2018, time=2018-10-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=349391, encodeId=626f349391f6, content=学习了长知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Mon Oct 15 07:41:13 CST 2018, time=2018-10-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=349390, encodeId=65b33493908e, content=学习了长知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Mon Oct 15 07:41:07 CST 2018, time=2018-10-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=349389, encodeId=8b13349389b6, content=学习了长知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Mon Oct 15 07:41:03 CST 2018, time=2018-10-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=349388, encodeId=85c134938876, content=学习了长知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Mon Oct 15 07:40:57 CST 2018, time=2018-10-15, status=1, ipAttribution=)]
    2018-10-15 Y—xianghai

    学习了长知识

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=1982630, encodeId=e4c7198263047, content=<a href='/topic/show?id=5b1ae87683' target=_blank style='color:#2F92EE;'>#GBS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7876, encryptionId=5b1ae87683, topicName=GBS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=30bd35, createdName=一叶知秋, createdTime=Tue Aug 06 22:06:00 CST 2019, time=2019-08-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1837578, encodeId=55ff183e57884, content=<a href='/topic/show?id=3f34e253206' target=_blank style='color:#2F92EE;'>#相关性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72532, encryptionId=3f34e253206, topicName=相关性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a9de34, 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likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Mon Oct 15 07:40:57 CST 2018, time=2018-10-15, status=1, ipAttribution=)]
    2018-10-15 Y—xianghai

    学习了长知识

    0

  10. 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    2018-10-15 Y—xianghai

    学习了长知识

    0

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