新型冠状病毒相关性吉兰－巴雷综合征

Severe acute respiratory syndrome corona virus 2 associated Guillain-Barré syndrome

摘要:

自2019 年 12月首次报道新型冠状病毒(SARS-CoV-2)以来，世界各国相继出现了大量SARS-CoV-2感染的病例，其发病率和死亡率均较高。SARS-CoV-2主要累及呼吸系统，也可累及其他系统，包括神经系统。与SARS-CoV-2相关的神经系统症状和疾病包括头痛、头晕、抑郁、嗅觉丧失、脑炎、中风、癫痫发作和吉兰－巴雷综合征等。吉兰－巴雷综合征(GBS)是一种炎症性多发性神经根神经病，可能由各种病毒和细菌感染引起的自身免疫介导的急性炎症脱髓鞘性疾病，这些感染因素使免疫系统被激活，导致神经根和周围神经受到损伤，主要表现为多发神经根及周围神经损害。近期越来越多的证据表明，SARS-CoV-2可以导致GBS，随着SARS-CoV-2感染的病例不断上升，因此，对SARS-CoV-2感染相关的GBS体征和症状的评估应引起重视，如果不能及时识别，可能会增加病毒感染的致死率。目前，对SARS-CoV-2相关性GBS尚认识不足，SARS-CoV-2与GBS之间的联系及发病机制并不明确。该文就SARS-CoV-2特点、SARS-CoV-2相关性GBS的临床表现、可能发病机制及治疗方面进行综述。

Abstract:

Since the first report of severe acute respiratory syndrome coronavirus 2 （SARS-CoV-2） in December 2019， a large number of SARS-CoV-2 infection cases have appeared in many countries around the world with high morbidity and mortality rates.SARS-CoV-2 mainly affects the respiratory system and can also involve other systems including the nervous system. Neurological symptoms and diseases associated with SARS-CoV-2 include headache， dizziness， depression， anosmia， encephalitis， stroke， seizures， and Guillain-Barré syndrome （GBS）.GBS is an inflammatory polyradiculoneuropathy， which is an autoimmune-mediated acute inflammatory demyelinating disease that may be caused by various viral and bacterial infections， and these infectious factors activate the immune system and lead to the damage of the nerve root and peripheral nerves， mainly manifesting as multiple nerve root and peripheral nerve damage. Recently， an increasing number of evidence has shown that SARS-CoV-2 is associated with GBS， and with the gradual increase in the number of SARS-CoV-2 infection cases， evaluation of the signs and symptoms of GBS associated with SARS-CoV-2 infection should be taken seriously in clinical practice. If such signs and symptoms are not identified in time， it may increase the mortality rate of viral infection. At present， there is still a lack of knowledge of SARS-CoV-2-associated GBS， and the link between SARS-CoV-2 and GBS and related pathogenesis remain unclear. This article reviews the characteristics of SARS-CoV-2 and the clinical manifestations， possible pathogenesis， and treatment management of SARS-CoV-2-associated GBS.