格林巴利综合征的临床与神经电生理分析  

Clinical and Electrophysiological Analysis of Guillain-Barre Syndrome

作　　者：包敏[1] 杨业新[2] 肖克娜[1] 胡荣荣[1] 徐萍[1] 梅元武[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院神经内科,武汉430022 [2]中国地质大学医院神经内科,武汉430030

出　　处：《神经损伤与功能重建》2009年第3期196-199,共4页Neural Injury and Functional Reconstruction

摘　　要：目的:总结格林巴利综合征(GBS)的临床和电生理参数异常分布情况,明确电生理对GBS的临床应用价值。方法:回顾分析38例GBS患者的临床及电生理资料,对运动神经传导速度(MCV)、F波、感觉神经传导速度(SCV)、肌电图的检测结果进行统计,观察其与临床表现的相关性。结果:本组患者感觉神经传导异常率低于运动神经传导异常率(P<0.05);上肢MCV异常率(24.40%)低于下肢(34.52%)(P<0.05);50%神经F波出波率降低或未引出波形;神经传导异常程度与脑脊液蛋白升高程度存在正相关关系;51.35%患者肌电图表现为神经源性损害;四肢远端肌肉正锐波、纤颤电位出现率(31.25%)与近端(21.57%)无统计学差异。结论:本组患者在电生理上既有神经脱髓鞘损害,亦有继发性轴索损害表现,远端运动神经损伤较感觉神经损伤重,下肢神经损伤较上肢重,神经损伤程度与病情相关,与病程未体现出明显的关系。Objective： To study the clinical and electrophysiological features of patients with Guillian-Barre Syndrome （GBS） and evaluate its significance in diagnosis. Methods： Retrospective analysis was performed to analyze the clinical and electrophysiological examination data of 38 patients with GBS diagnosed in our hospital from 2001 to 2007. The association between their clinical characteristics and motor conduction veloeity（MCV）, sensory conductive velocity（SCV）, F wave and EMG were investigated. Results： The abnormal rate of MCV（42.86% ） was higher than that of SCV（26.19%） （P〈0.05）. The abnormal rate of distant MCV of lower extremities （34.52%） was higher than that of upper extremities （24.4%）（P〈0. 05）. F wave abnormality was 43.33%. The degree of nerve conduction abnormalities correlated positively with concentrations of proteins in CSF. 51. 35G of EMG revealed the neurogenic damage. There was no significant difference between the rate of fibrillation potential and positive sharp wave in proximal and that of distal muscles of limbs. Conclusion： Nerve demyelination and secondary axonal damage in patients with Guillian-Barre Syndrome （GBS） can be decteeted by eleetrophysiologieal study. The injury of distal motor nerve is more severe than the sensory nerve. The damage of nerve in the lower limbs is more severe than the upper limbs.

关 键 词：急性格林巴利综合征 电生理 神经传导 

分 类 号：R741[医药卫生—神经病学与精神病学] R745.43[医药卫生—临床医学]