HIV感染中的神经病变。

Bailliere's clinical neurology Pub Date : 1996-03-01
M C Dalakas, E J Cupler
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引用次数: 0

摘要

周围神经病变是HIV感染患者最常见的神经系统表现,发生在感染早期或疾病过程中。它们表现为急性或慢性脱髓鞘神经病变(格林-巴勒综合征或慢性炎性脱髓鞘多神经病变)、多发性单神经炎、神经节神经炎、巨细胞病毒相关的多神经根神经病变、自主神经病变或远端疼痛感觉神经病变。它们的病因是多因素的。其假定的病因(病毒性、自身免疫性、毒性、营养性、合并感染)往往取决于潜在HIV疾病的阶段。这种病毒不存在于神经节神经元或雪旺细胞中,而只存在于神经内膜巨噬细胞中,它可能通过分泌细胞因子来产生组织特异性自身免疫攻击,促进神经内膜实质内活化的T细胞和巨噬细胞的运输。神经毒性抗逆转录病毒核苷类似物ddC、ddI、d4T和3TC的广泛使用,加剧或引发许多此类患者的亚临床神经病变。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Neuropathies in HIV infection.

Peripheral neuropathies represent the most common neurological manifestation in patients infected with HIV infection occurring either early in the infection or during the course of the illness. They present as acute or chronic demyelinating neuropathies (Guillain-Barré syndrome or chronic inflammatory demyelinating polyneuropathy), mononeuritis multiplex, ganglioneuronitis, cytomegalovirus-related polyradiculoneuropathy, autonomic neuropathy or distal painful sensory neuropathy. They are multifactorial in aetiology. Their putative cause (viral, autoimmune, toxic, nutritional, co-infections) are often dictated by the stage of the underlying HIV disease. The virus, which is not found within ganglionic neurones or Schwann cells but only within the endoneurial macrophages, may generate a tissue-specific autoimmune attack by secretion of cytokines that promote trafficking of activated T cells and macrophages within the endoneurial parenchyma. The wide use of the neurotoxic antiretroviral nucleoside analogues ddC, ddI, d4T and 3TC, exacerbate or trigger subclinical neuropathy in many of these patients.

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