儿童吉兰-巴雷综合征临床与神经电生理特点及预后  

Children with Guillain-Barre Syndrome:Clinical and Electrophysiological Features and Prognosis

作　　者：罗君[1] 黄明勇[1] 李兆宝[1] LUO Jun HUANG Ming-yong LI Zhao-bao(Department of Rehabilitation, Suizhou Hospital, Hubei University of Medicine, Suizhou, Hubei 441300, China)

机构地区：[1]湖北医药学院附属随州医院康复医学科,湖北随州441300

出　　处：《湖北医药学院学报》2017年第3期232-235,共4页Journal of Hubei University of Medicine

基　　金：随州市卫生计生委科研项目(2015SMR026)

摘　　要：目的:探讨随州地区儿童吉兰-巴雷综合征(GBS)的临床特征,电生理特点及其预后。方法:对2013年3月-2016年3月间38例GBS患儿的临床和神经电生理资料进行分析和随访。结果:⑴临床特征:肢体无力为患儿就诊时主诉症状,多有前驱感染史(81.85%,n=31),其中以非特异性上呼吸道感染为主,秋季(9~11月)为发病高峰季节。⑵神经电生理检查:急性炎性脱髓鞘性多神经根神经病(AIDP)为最常见疾病类型(57.89%,n=22),神经电生理最常见的异常包括运动神经复合肌肉动作电位(CMAP)降低和传导阻滞。⑶治疗与随访:大部分患儿在急性期应用免疫球蛋白治疗,4例患儿因呼吸肌受累需要进行辅助呼吸,随访一年后,33例患儿完全恢复,5例患儿遗留不同程度后遗症,无死亡病例。结论:GBS患儿多以肢体无力或疼痛为就诊主诉,大多有前驱感染史,疾病类型主要为AIDP,神经电生理检查在GBS患儿早期诊断中阳性率高,轴索损害疾病进展更快、肢体瘫痪重、后遗症患儿更多。Objective To investigate the clinical and electrophysiological characteristics and prognosis of children with Guillain-Barre syndrome（ GBS） in Suizhou area. Methods The clinical and electrophysiological data were collected and analyzed on 38 children with GBS who were hospitalized at our hospital during the period of March 2013 to March 2016. Results Autumn（ 9 ~ 11 months） was the peak season of the disease. Limb weakness was the main and early symptom（ 65.79%）. The majority of patients（ 81.85%） had a history of pre-infection,mainly nonspecific upper respiratory tract infection. Acute inflammatory demynelianting polyneuropathy（ AIDP） was the most common type of the disease（ 57.89%）. The most common abnormalities in electrophysiology include the reduction of CMAP and conduction block. Most of the patients were treated with immunoglobulin in the acute stage,and 4 of them required respiratory assistance due to the weakness of their respiratory muscle. After one year of follow-up,33 patients recovered completely,and 5 patients had different degrees of sequelae,and there were no deaths.Conclusion GBS patients mostly suffered from limb weakness or pain,most of which had the history of precursor infection. AIDP was the main type of the disease. The higher positive rate of electrophysiological examination could be conducive to the early diagnosis of GBS and predict the progress of axonal damage,limb paralysis and sequelae.

关 键 词：儿童 吉兰-巴雷综合征 临床 电生理 

分 类 号：R745.43[医药卫生—神经病学与精神病学]