鞘内注射地塞米松联合静滴大剂量人免疫球蛋白治疗急性格林—巴利综合征的临床研究  

Clinical research on intrathecal injection of dexamethasone combined with large dose of intravenous administration human immunoglobulin to treat acute guillain-barre syndrome

作　　者：樊金莲[1] 

机构地区：[1]广西贵港市人民医院神经内科,广西贵港537100

出　　处：《热带医学杂志》2015年第4期521-523,541,共4页Journal of Tropical Medicine

摘　　要：目的观察鞘内注射地塞米松联合静滴大剂量人免疫球蛋白治疗急性格林—巴利综合征的临床疗效。方法选择确诊为急性格林—巴利综合征的患者46例,随机分为观察组和对照组,每组23例。对照组给予常规治疗,观察组在常规治疗基础上联合鞘内注射地塞米松及静滴大剂量人免疫球蛋白治疗,其中鞘内注射1次/周,每次鞘内注射地塞米松10 mg,5次为1个疗程。治疗过程中动态观察脑脊液(CSF)中蛋白含量及细胞学变化,比较治疗前后临床神经功能缺损程度评分(SSS)变化及临床疗效、肌电图变化,并进行疗效评价。结果观察组患者CSF蛋白含量恢复至正常、CSF细胞学检查、肌电图检查改善或恢复至正常的时间较对照组提前。观察组起效时间、SSS评分及临床症状改善明显优于对照组,差异均有统计学意义(P<0.01)。观察组显效率明显高于对照组,差异有统计学意义(P<0.05)。结论鞘内注射地塞米松联合静滴大剂量人免疫球蛋白治疗急性重症格林-巴利综合征安全有效,缩短病程,缓解急性期症状效果明显,值得临床推广应用。Objective To explore the clinical effect of given intrathecal injection of dexamethasone（DXM） combined with large dose of intravenous administration human immunoglobulin to treat acute guillain-barre syndrome.Methods 46 patients diagnosed with acute guillain-barre syndrome were randomly divided into observation group and control group.Patients in the observation group were given intrathecal injection of dexamethasone combined with large dose of intravenous administration human immunoglobulin,once a week with 10 mg intrathecal injection of dexamethasone for 5 times,and the dynamic of the concentration of protein and the variation of cytology in cerebrospinal fluid（CSF） during the course were observed.The change of clinical nerve function defect degree scale（SSS） and clinical effect and evaluate the curative effect of electromyography before and after the treatment were compared.Results The CSF protein in the observation group of patients came back to normal level.Compared with the control group,the CSF cytology and electromyography examination in observation group showed improvement or restoration up more than 1 week in advance.The clinical course of observation group took shorter than the control group obviously.The degree of clinical neural function defect scale（SSS） and the clinical effect in observation group improved significantly than that of the control group.Differences were statistically significant（P〈0.01）.Comparison of two groups of clinical effect revealed that the efficiency of observation group was apparently better than that of control group（P〈0.05）.Conclusion Given intrathecal injection of dexamethasone combined with large dose of intravenous administration human immunoglobulin to treat acute guillain-barre syndrome is safe and effective.It can shorten the therapy course and alleviate symptoms of acute stage significantly.In conclusion,it is worthy of further promotion and study.

关 键 词：格林—巴利综合征 鞘内注射地塞米松 静滴人免疫球蛋白 

分 类 号：R744.5[医药卫生—神经病学与精神病学]