伴脑神经功能缺损的吉兰-巴雷综合征临床特征及相关因素分析  

Clinical Characteristics and Related Factors Associated with Cranial Nerve Involved Guillain-Barre Syndrome

作　　者：李微微 顾健[1] LI Wei-wei;GU Jian(Shengjing Hospital Affiliated to China Medical University , Shenyang 110000)

机构地区：[1]中国医科大学附属盛京医院

出　　处：《中国临床神经科学》2019年第3期267-272,293,共7页Chinese Journal of Clinical Neurosciences

摘　　要：目的探讨伴脑神经功能缺损的吉兰-巴雷综合征(GBS)的临床特点,以及脑神经功能缺损相关危险因素。方法收集17例伴脑神经功能缺损(脑神经功能缺损组)和30例不伴脑神经功能缺损(对照组) GBS患者的临床资料,回顾性分析比较两组临床特点及相关辅助检查结果,以及引起脑神经功能缺损的相关因素。结果脑神经功能缺损组17例,其中男10例、女7例,平均年龄(36. 71±18. 47)岁,脑神经功能缺损发生率5. 1%。面神经受累11/17例(64. 71%)最为常见。单因素分析:自主神经功能障碍(χ~2=6. 049,P=0. 014)、入院时MCR评分≤30 (χ~2=4. 821,P=0. 028)、呼吸肌麻痹(χ~2=4. 236,P=0. 039)、电生理提示周围神经轴索性损害(χ~2=5. 347,P=0. 021)与GBS患者脑神经受损有关;多因素Logistics回归分析:自主神经功能障碍(OR=4. 800,95%CI:1. 321~17. 441;P=0. 017)与脑神经受损独立相关。结论伴脑神经功能缺损的GBS临床少见,以面神经损伤最为常见;自主神经功能障碍、入院时MCR评分<30、呼吸肌麻痹和电生理提示轴索损害可能与脑神经损伤有关,其中自主神经功能障碍与GBS脑神经损伤独立相关。Aim To investigate the clinical features and related factors of cranial nerve involved Guillain-Barre syndrome( GBS). Methods Retrospectively analyzed 17 cases of GBS with cranial nerve involved as a research group,30 cases diagnosed GBS inpatients without cranial nerve involvement as a control group,stratifying random pairing rules drawn. Compared clinical data of the two group patients,the clinical differences and further inferred possible risk factors associating with cranial nerve damage of GBS were observed and analyzed. Results 17 cases( 10 males,7 females,mean age 36. 71 ± 18. 47 years),the incidence of cranial nerve involvement was 5. 1%. Among them,the facial nerve involvement in 11 cases( 64. 71%) was the most common. Unvaried analysis found that autonomic dysfunction( χ^2= 6. 049,P = 0. 014),admission MCR score < 30( χ^2= 4. 821,P = 0. 028),respiratory muscle paralysis( χ^2=4. 236,P = 0. 039),peripheral nerve electrophysiology showed axonal damage( χ^2= 5. 347,P = 0. 021)was related with cranial nerve impairment in GBS patients. Multi-logistic regression analysis showed that autonomic dysfunction( OR = 4. 800,95% CI: 1. 321,P = 0. 017) was independently associated with impaired cranial nerve in GBS. Conclusion Cranial nerve involved is rare in GBS patients,facial nerves is the most common. Autonomic dysfunction,admission MCR score < 30,respiratory muscle paralysis and axonal damage may relate with cranial nerve involvement, autonomic dysfunction was independently associated with impaired cranial nerve.

关 键 词：吉兰-巴雷综合征 脑神经 双侧面瘫 

分 类 号：R746[医药卫生—神经病学与精神病学]