重症吉兰-巴雷综合征的预测因素分析  

Predictors for sever Guillain-Barré syndrome

作　　者：谢春格[1] 王丽敏[1] 何雪桃[1] 陈洁玲[1] 

机构地区：[1]广东省人民医院神经内科神经电生理室,广东省医学科学院,广东省神经科学研究所,广州510030

出　　处：《中国神经精神疾病杂志》2016年第8期484-487,共4页Chinese Journal of Nervous and Mental Diseases

基　　金：广东省医学科学技术研究基金(编号:B2015088)

摘　　要：目的分析轻症与重症吉兰一巴雷综合征（Guillain—Barr6syndrome，GBS）患者临床及神经电生理检查特点，筛选出重症患者的预测因素。方法回顾性分析2006年1月至2015年11月在本院住院治疗的GBS患者101例。根据疾病高峰期Hughes评分划分为轻症组（0-2分）和重症组（3-6分）。分别统计两组患者发病年龄、性别、前驱感染史、首发症状、是否有延髓功能障碍、是否累及颅神经和自主神经、有无轴索损害等指标，分析两组之间差异，并筛选出重症患者的预测因素。结果以非感觉异常为首发症状（P〈O．001）、有延髓功能障碍（P〈0．001）、颅神经受累（P=O．025）、自主神经系统受累（P=O．018）、运动系统受累（P=0．004）以及轴索损害（P〈O．001）的患者容易发展为重型患者。多因素Logistic回归分析发现轴索损害（P=0．008，OR=4．632）、延髓受累（P=O．010,OR=10．420）、颅神经受累（P=0．047，OR=0．076）是发展为重型的独立危险因素。结论轴索损害、延髓受累和颅神经受累可能是GBS患者发展至重型的有意义的预测因素。Objectives To explore different factors （clinical presentations and laboratory investigations ） between the severe and mild Guillain-Barr6 syndrome （GBS） in southeast China ,and to find the predictors of severe GBS. Meth- ods Retrospective analysis was conducted on 101 eases of patients with GBS admitted to our Hospital from Jan. 2006 to Nov. 2015, who were divided into mild and severe groups according to Hughes scale. The different factors were compared between these two groups such as age, sex, precursor infection factors, the initial symptoms, bulbar dysfunction, cranial nerves involvement, autonomic nervous dysfunction, peripheral nerve axonal damage to find the predictors for the severe GBS. Results Severe GBS more frequently presented with non-paresthesia as initial symptom （P〈0.001）, bulbar dysfunc- tion （P〈0.001）, cranial nerves involvement （P=0.025）, autonomic nervous dysfunction （P=0.018）, motion system involve- ment （P = 0.004） and peripheral nerve axonal damage （P〈0.001）. After multivariable logistic regression analysis, we found .that the axon damage （P=0.008, 0R=4.632）, bulbar dysfunction （P=0.010, OR=10.420）, and cranial nerves in- volvement （P=0.047, 0R=0.076）were the independent risk factors for sever GBS. Conclusion Axon damage, bulbar dysfunction, and cranial nerves involvement might be significant predictors of sever GBS.

关 键 词：吉兰-巴雷综合征 疾病严重程度 预测 

分 类 号：R745.43[医药卫生—神经病学与精神病学]