免疫介在性ニューロパチーの発生状況と危険因子の分析：単一施設症例対照研究

To investigate the epidemiological characteristics of immune-mediated neuropathies (primarily including Guillain-Barré Syndrome and Chronic Inflammatory Demyelinating Polyradiculoneuropathy) and systematically analyze their associated risk factors, providing a theoretical basis for disease prevention and early intervention.

A retrospective study was conducted. 158 patients with immune-mediated neuropathies admitted to our hospital between January 2020 and December 2023 were selected as the case group, while 160 healthy individuals undergoing physical examinations during the same period were selected as the control group. Demographic data and clinical records (including history of preceding infections, vaccination history, history of comorbid diseases, etc.) were collected and compared for all subjects. Univariate analysis and multivariate logistic regression analysis were used to identify independent risk factors for immune-mediated neuropathies.

The annual incidence of immune-mediated neuropathies was 1.24 per 100,000, with a bimodal age distribution (20-30 years and 50-70 years). The incidence was slightly higher in males than in females (1.5:1). Univariate analysis showed statistically significant differences (p < 0.05) between the case and control groups in terms of history of preceding infection (particularly respiratory and gastrointestinal infections), recent vaccination history, history of surgical trauma, and comorbid autoimmune diseases. Multivariate logistic regression analysis further confirmed that preceding Campylobacter jejuni infection (OR = 4.52, 95% CI: 2.81-7.26, p = 0.000), Cytomegalovirus infection (OR = 3.18, 95% CI: 1.95-5.19, p = 0.000), recent surgical trauma (OR = 2.45, 95% CI: 1.40-4.29, p = 0.002), and the presence of an underlying autoimmune disease (OR = 2.90, 95% CI: 1.72-4.89, p = 0.000) were independent risk factors for the onset of immune-mediated neuropathies.

The onset of immune-mediated neuropathies is closely related to various environmental and individual factors. Preceding infections (especially Campylobacter jejuni and Cytomegalovirus) are the most significant independent risk factors. In clinical practice, high suspicion for immune-mediated neuropathies should be maintained for individuals with the aforementioned risk factors who present with neurological symptoms, to achieve early diagnosis and treatment.