糖尿病酮症酸中毒合并吉兰-巴雷综合征2例临床分析  

Clinical Features of Diabetic Ketoacidosis Associated with Guillain-Barré Syndrome in two Patients

作　　者：王丽[1] 陈会生[1] 刘娟丽[1] 王婷婷[1] 李晓龙[1] 

机构地区：[1]沈阳军区总医院神经内科,辽宁沈阳110016

出　　处：《现代生物医学进展》2016年第6期1101-1103,共3页Progress in Modern Biomedicine

基　　金：辽宁省科技攻关计划项目(2013225089)

摘　　要：目的:研究糖尿病酮症酸中毒(diabetic ketoacidosis,DKA)合并吉兰-巴雷综合征(Guillain-Barrésyndrome,GBS)的临床特点,以探讨其临床表现、治疗、预后及发病机制。方法:回顾性分析2例DKA合并GBS患者的病例资料,对其病史、临床表现、电生理学、脑脊液改变、治疗进行总结。结果:2例DKA患者均急性起病,两例患者发病前1周均有呼吸道感染史,尽管DKA得到了纠正,患者出现呼吸衰竭后被发现四肢力弱。肌电图提示周围神经损害。脑脊液示细胞蛋白分离。给予免疫球蛋白后,例1在出现肢体瘫痪后18天恢复至正常,遗留有四肢末端麻木感,例2在出现肢体瘫痪后1年肌力恢复正常。结论:DKA合并GBS临床少见,多发生在DKA纠正后一周左右出现四肢迟缓性瘫痪,早期给予免疫球蛋白治疗,预后相对良好,目前发病机制尚不清楚。Objective：To explore the clinical manifestations,diagnosis,treatment,prognosis and pathogenesis of diabetic ketoacidosis（DKA） associated with Guillain-BarréSyndrome（GBS） in two patients.Methods：We reviewed the history,clinical manifestations,electrophysiological characteristics,laboratory features of CSF and treatment of 2 patients with DKA and GBS.Results：Both of the two patients showed acute onset with respiratory tract infection history before a week.Although they recovered from the state of diabetic ketoacidosis,they suffered the four limbs motor weakness after a week.Electromyography showed evidence of peripheral neuropathy.Cerebrospinal fluid analysis showed albuminocytolgoic dissociation.Treatment with immunglobulin resulted in improved prognosis of the patients.One patient had complete recovery from the motor paresis and loss of sensation in the lower extremities on the eighteenth day,the other patient had complete recovery by a year after the onset of symptoms.Conclusions：DKA combined with GBS is rare,and the outcome is favorable after immunglobulin treatment in the early stage of disease,but the etiology and pathogenesis of DKA associated with GBS are unclear.

关 键 词：糖尿病酮症酸中毒 吉兰-巴雷综合征 临床表现 脑脊液检查 肌电图 

分 类 号：R587.2[医药卫生—内分泌]