类固醇治疗Guillain-Barre综合征的疗效评价  

Evaluation on the efficacy of steroid therapy in patients with Guillain-Barre syndrome

作　　者：刘汝宏[1] 丛志强[2] 李江[2] 陈燕[2] 

机构地区：[1]山东省胜利油田中心医院神经内科,257034 [2]青岛大学医学院附属医院神经内科

出　　处：《临床神经病学杂志》2002年第2期97-99,共3页Journal of Clinical Neurology

摘　　要：目的　评价类固醇治疗 Guillain- Barre综合征 (GBS)的有效性及安全性。方法　按 Hughes运动功能缺损评分法 ,对 5 6例运动功能缺损评分≥ 3分的 GBS患者分成类固醇治疗组与非类固醇治疗组进行回顾性研究 ,观察两组运动功能缺损评分的动态变化 ,病程 1年时的后遗症 ,以及类固醇的副反应。结果　 (1)GBS患者发展至高峰的时间及高峰时病情与是否应用类固醇无关 (P>0 .0 5 ) ,但高峰期持续的时间 ,改善 1分所需时间 ,达到 2分所需时间 ,以及平均住院日 ,类固醇治疗组明显短于非类固醇治疗组 (P <0 .0 5 )。 (2 )在病程 1个月、3个月时 ,类固醇治疗组较非类固醇治疗组运动功能缺损评分明显低 (P <0 .0 5 ) ,但自 6个月起 ,两组运动功能缺损评分无差异 (P>0 .0 5 ) ,在 1年时的后遗症发生率及其程度两组相近 (P>0 .0 5 )。 (3)主要副反应为 Cushing反应及易患上呼吸道感染。结论　类固醇能加快 GBS的恢复 ,缩短平均住院日 ,但对 1年时后遗症的发生率及其程度无影响。Objective To evaluate the efficacy and safety of steroid therapy in patients with Guillain Barre syndrome (GBS).Methods In this retrospective study, 56 patients with GBS (the grading scale of functional disability ≥3) were divided into steroid group and no steroid group by Hughes' grading scale of functional disability.The change on the grading scale of functional disability, the sequel of course of disease for 1 year,and the side reaction of steroid in the two groups were as well as observed.Results (1) No correlation was found between the time from the onset of illness to the peak, the severity of the peaking period and steroid therapy( P >0.05),but the duration of the peaking period, the time for improving one grade, the time for reaching 2 grade, and the hospitalization was significantly shorter in patients treated with steroid than without steroid(P<0.05). (2) Grades of functional disability were lower in the steroid group than no steroid group during 1,3 months in the course, from the beginning of 6 months there was no difference between them(P<0.05),the incidence rate of the sequel and the severity of the disability at 1 year in the two groups were quite similar( P >0.05). (3) The major side effects included Cushing's reaction and the infection of the upper respiratory tract.Conclusion Steroids can quicken the recovery of GBS, and shortened average hospitalization in patients with GBS, but steroid doesn't alter the incidence rate of the sequel and the severity of the disability at 1 year in the course.It has no side reaction to use steroid reasonably.

关 键 词：GUILLAIN-BARRE综合征 类固醇 治疗 疗效评价 

分 类 号：R745.43[医药卫生—神经病学与精神病学]