吉兰—巴雷综合征临床分型与预后

发布时间：2018-11-20 19:13

【摘要】：目的:通过对吉兰-巴雷综合征的临床分型和预后进行分析,探讨吉兰-巴雷综合征各亚型临床特点、预后及影响预后的相关因素。 方法:收集重庆医科大学附属第一医院2006年-2013年收治的170例吉兰-巴雷综合征患者的临床资料进行分析,并根据临床表现、电生理表现分为急性炎症性脱髓鞘性多发神经病(acute inflammatorydemyelinating polyneuropathy,AIDP)、急性运动轴索性神经病(acutemotor axonal neuropathy,AMAN)、Miller-Fisher综合征(Miller-Fishersyndrom,MFS)、脑神经型(cranial nerve variants,CNV）、Bicherstaff脑干脑炎叠加吉兰巴雷综合征(Bickerstaff's brainstem encephalitis overlapswith Guillain-Barre syndrome,BBE-GBS)和其他组。采用χ2检验分析各型GBS临床特点,对随访到的139例患者采用重复测量方差分析及多因素Logistic回归分析进行预后及预后相关因素的分析。 结果:AIDP组97例(57%)，AMAN组37例(22%)，MFS组12例(7%)，脑神经组8例(5%)，BBE-GBS组8例(5%)，其他组8例（5%）。据各组间3个月及6个月HFGS评分比较各组间预后，AMAN组与BBE-GBS组之间3个月预后（F值=3.29，P=0.0704）与6个月预后（F值=1.97，P=0.1614）均无统计学差异；AMAN组与AIDP组3个月(F值=10.33，P=0.0014)、6个月(F值=15.26，P=0.0001)预后有统计学差异；MFS组（0.72±0.79）、脑神经型（0.29±0.49）6个月预后均良好。Logistic回归分析显示病情达峰时HFGS评分≥3分[P0.0001，OR=6.650、95%CI(2.865,15.023)],自主神经功能障碍[P=0.0435， OR=2.820、95%CI(1.031,7.715)]与预后不良(HFGS评分1分)有关。 结论:AIDP为GBS主要亚型；AMAN组和BBE-GBS组3个月与6个月预后均较AIDP组差；脑神经型GBS与MFS预后良好；重型患者、自主神经功能障碍为GBS预后不良预测因素。
[Abstract]:Objective: to study the clinical characteristics, prognosis and related factors of Guillain-Barre syndrome (GBS) by analyzing the clinical classification and prognosis of Guillain-Barre syndrome. Methods: the clinical data of 170 patients with Guillain-Barre syndrome admitted from 2006 to 2013 in the first affiliated Hospital of Chongqing Medical University were collected and analyzed. The electrophysiological manifestations were as follows: acute inflammatory demyelinating multiple neuropathy (acute inflammatorydemyelinating polyneuropathy,AIDP), acute motor axis neuropathy (acutemotor axonal neuropathy,AMAN), Miller-Fisher syndrome (Miller-Fishersyndrom,MFS), cerebral (cranial nerve variants,CNV. Bicherstaff brainstem encephalitis superimposed (Bickerstaff's brainstem encephalitis overlapswith Guillain-Barre syndrome,BBE-GBS and other groups. The clinical features of various types of GBS were analyzed by 蠂 2 test. The prognostic and prognostic factors were analyzed by repeated measurement analysis of variance and multivariate Logistic regression analysis. Results: 97 cases (57%), AMAN, 37 cases (22%), MFS, 12 cases, 7%) in AIDP group, 8 cases (5%) in brain nerve group, 8 cases (5%) in BBE-GBS group, 8 cases (5%) in other groups. According to the HFGS scores of 3 and 6 months, there was no significant difference in the prognosis between the AMAN group and the BBE-GBS group in 3 months (F = 3.29 P0. 0704) and 6 months (F = 1. 97 P0. 1614). The prognosis of AMAN group was significantly different from that of AIDP group at 3 months (F = 10. 33) and 6 months (F = 15. 26 P0. 0001). The prognosis of MFS group (0.72 卤0.79) and cerebral nerve type (0.29 卤0.49) was good at 6 months. Logistic regression analysis showed that the HFGS score was 鈮，

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