目的 探讨合并血浆单唾液酸神经节苷脂(GM 1)抗体阳性的急性脊髓炎(AM)患儿的临床特点及治疗.方法 回顾分析2例患儿的临床资料,并随访3个月;同时复习相关文献.结果 2例AM患儿,男女各1例,均为5岁,均有脊髓炎表现并伴有影像学改变,血清GM 1-IgM和甲状腺抗体均为阳性,同时血清幽门螺杆菌抗体IgG阳性,1例肺炎支原体IgM抗体阳性.大剂量激素及丙球治疗后均好转出院.院外继续口服泼尼松并康复治疗,随访3个月后1例恢复,1例可下肢承重.结论 免疫损伤在伴有GM 1抗体阳性的儿童急性脊髓炎发病中有重要作用,其临床治疗效果及预后较好.%Objective To investigate clinical characteristics and treatment of acute myelitis in children. Methods Clinical data and prognosis of two cases of pediatric acute myelitis with positive serum monosialoganglioside (GM1) antibodies were analyzed, and related literatures were reviewed. Results Two cases had clinical symptoms and MRI change of myelitis with positive serum GM1-IgM antibody and thyroid antibody. Two cases had positive serum Helicobacter pylori IgG antibody and one case has positive Mycoplasma pneumoniae IgM antibody.After treated with high doses of glucocorticoid and gamma-globulin, two cases were discharged as symptoms improved. After discharged, treatment with oral prednisone and rehabilitation were continued. One case recovered completely while another could stand alone by supporting after 3 months follow-up. Conclusion Immunologic injury played an important role in pathogenesis of acute pediatric myelitis with serum positive GM1 antibodies, which had better treatment outcome and prognosis. This type of myelitis may have intestinal Helicobacter pylori infection.
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