摘要
目的探讨吉兰-巴雷综合征(Guillain-Barrésyndrome,GBS)早期临床症状和实验室检查与疾病高峰期病情严重程度的关系,筛选出预测性指标,以指导其早期的干预措施和治疗方案。方法收集2005-2012年长沙市第一医院收治的GBS患者63例,根据患者发病高峰期Hughes评分划分病情等级(轻型和重型),分析疾病最终严重程度与腹泻史、延髓功能障碍、自主神经功能障碍、周围神经轴索损伤、脑脊液蛋白升高、CD4+/CD8+值增高等因素的相关性。结果急性期GBS患者中,有前驱感染腹泻史、延髓功能障碍、自主神经功能障碍、周围神经轴索损伤、脑脊液蛋白升高及CD4+/CD8+值增高者易发展为重型患者(P=0.031,OR=4.652;P=0.035,OR=15.832;P=0.041,OR=4.507;P=0.009,OR=9.754;P=0.034,OR=3.215;P=0.047,OR=1.712)。结论前驱腹泻史、延髓功能障碍、自主神经功能障碍、周围神经轴索损伤、脑脊液蛋白升高、CD4+/CD8+值增高可能是GBS患者病情发展至重型的有意义的预测因素。
Objective To explore the factors related to the severity of Guillain Barre syndrome （GBS）. Methods Data of 63 patients with GBS admitted to the First Hospital in Changsha City from 2005-2012 were collected. Then the patients were divided into two groups according to Hughes scale （mild group and severe group）, and we analyzed the factors related to the eventual severity of the diseases. Finally, we analyzed the relationship between the eventual severity of the disease with diarrhea history, bulbar dysfunction, autonomic nervous dysfunction, peripheral nerve axonal injury, cerebrospinal fluid protein level, and CD4^＋/CD8^＋ value. Results A worse Hughes score in the acute phase of the diseases was related to early stage diarrhea infection, bulbar dysfunction, and autonomic nervous system involvement. The severe patients more frequently had neuraxon impairment, increased cerebrospinal fluid protein, and higher CD4^＋/CD8^＋ ratio （P= 0. 031, OR= 4.652; P=0.035, OR=15.832; P=0.041, OR 4.507; P=0.009, OR=9.754; P=0.034, OR=3.215; P =0. 047, OR= 1. 712）. Conclusions Predictive clinical factors of severe GBS patients were previous diarrhea history, bulbar dysfunction, autonomic nervous dysfunction, neuraxon impairment, increased cerebrospinal fluid protein, and higher CD4^＋/CD8^＋ ratio. Knowing these predictive factors might be helpful for early management of those who are likely to become severe GBS .
出处
《中国神经免疫学和神经病学杂志》
CAS
北大核心
2014年第4期265-268,共4页
Chinese Journal of Neuroimmunology and Neurology
关键词
吉兰-巴雷综合征
预测
因素
Guillain Barre syndrome
forecasting
factors
