Research Of Electromyography, Cerebrospinal Fluid And Peripheral Blood B Lymphocytes In Patients With Guillian-Barre Syndrome

Objective:This studies changes of EMG,cerebrospinal fluid And the detection of peripheral blood B lymphocyte surface antigen CD 19, CD22 expression in patients with Guillian-Barre syndrom and to explore the relationship between the severity ofGBS,Thus further revealing the pathogenesis of GBS.And define electromyography, cerebrospinal fluid, peripheral blood CD 19, CD22 value for clinical evaluation of GBS.Methods:32patients with GBS and 32 healthy controls (HC)were investigated.32 cases of GBS patients with electrophysiological testing and CSF examination, Record physical on both sides, upper and lower limbs distal motor nerve latency (DML), motor nerve conduction velocity (MCV), compound muscle action potential (CMAP) and sensory nerve conduction velocity (SCV), F wave, While expression of CD 19 and CD22 on peirpheral Blymphocytes were examined for 32 patients with GBS and 32 healthy controls by flow cytometry, And the results were statistically analyzed and the relationship between disease severity.Results:1.The abnormal rate of MCV (56.64%) was higher than that of SCV(42.58%) (X2 = 10.126,P<0.05). The abnormal rate of upper limb movement nerve conduction was 29.29%,and lower limb was 27.34%, no significant difference (X2=0.398,P> 0.05). The abnormal rate of peroneal nerve(18.75%)was higher than that of tibial nerve(8.59%) (X2= 21.312, P<0.05). But the abnormal rate of the median nerve (14.45%) and ulnar nerve (14.84%) was no significant difference (X2= 3.544, 4.237, P> 0.05), Left and right median nerve abnormality rate (7.42%,7.03%, X2= 0.064), left ulnar nerve abnormality rate (8.2%,6.64%, X2=1.036), left and right tibial nerve abnormality rate (4.3%,4.3%, X2= 0.000) Right and left peroneal nerve abnormality rate (8.59%,10.16%, X2= 2.003), there was no significant difference (P> 0.05).2.In GBS group,F wave latency abnormality was 50%, F wave emergence abnormalities was 44.53%, there was significant difference with normal subjects (X2=9.97, P<0.05).3.It was compared with this group of patients with bilateral limb motor nerve DML, CAMP abnormal rate:It was not statistically significant difference that Distal upper limb nerve (median, ulnar nerve) DML severe abnormality rate (25.8%) was compared with lower extremity distal nerve (tibial and common peroneal nerve) severe abnormality rate (29.7%) (X2=0.487,P>0.05). It was not statistically significant difference that Distal upper limb nerve (median, ulnar nerve) CAMP severe abnormality rate (50%) was compared with lower extremity distal nerve (tibial and peroneal nerve) CAMP severe abnormality rate (58.6%) (X2= 1.905, P >0.05).The Group of patients with bilateral median nerve, ulnar nerve, tibial nerve, peroneal nerve amplitude and latency of the movement also separately compared, no significant difference(P<0.05).4.Component type in the GBS patients, AIDP 24 patients, accounting for 75%, AMAN 8 patients, accounting for 25%, there was significant difference (X2=5.486, P> 0.05).5.In GBS group, CSF cell count between 0 to 10,CSF protein, in between 0.2～6g, mean for 1.18±0.19 g,7 cases of cerebrospinal fluid which is less than 0.45g,25 cases of cerebrospinal fluid protein were increased, there were cells-protein separation,accountingfor about78.1%.The degreeof nerve conduction abnormalities correlated positively with concentrations of proteins in CSF (Pearson= 3.978, P=0.046).32 cases of GBS patients with CD19+expression in the blood was no correlated with cerebrospinal fluid protein (Pearson= 0.076, P= 0.680). 6.The expression of CD19+,CD19+CD22+,CD19-CD22+ in peripheral blood B lymphocytes were 15.71±7.01,14.23±6.63,1.30±1.15 respectively in GBS group, they were 9.80±4.03,9.56±3.42,1.59±1.82 respectively in healthy controls. Compared with healthy controls, the expression of CD19+,CD19+CD22+were increased in GBS group (P<0.05),but the expression of CD19"CD22+was of no significant difference(P> 0.05).7.The expression of CD19+,CD19+CD22+in peripheral blood B lymphocytes were16.54±4.86,14.85±4.71 respectively in severe group,14.65±9.17,13.36±8.65 respectively in mild group. The expression of CD19+in severe group was higher than that of mild group(P<0.05). The expression of CD19+CD22+was of no significant differences in mild group,compared with severe group(P>0.05).Conclusions:1.Patients with GBS have motor neuron and sensory nerve damage, motor abnormalities 50.4%higher than the rate of abnormal sensory nerve injury rate of 41.7%.2.This group of GBS patients have not only nerve root damage, but also demyelination and axonal damage. Typing in the GBS, mainly in AIDP common.3.The extent of distal extremities of motor neuron damage were symmetry up and down,left and right in the group of patients, no significant difference.4. In the present study,week after onset of cerebrospinal fluid detected 78.1%of the patients in the cell-protein separation, CSF protein content was positively correlated with degree of motor impairment.5.The incidence of GBS may be related to peripheral blood B lymphocyte surface antigen CD19+,CD22+expression.In which the increase of CD 19+may be closely related to the severity of GBS,but the expression level of CD19+ peripheral blood was no correlated with cerebrospinal fluid protein content in GBS patients,...