摘要
目的探讨神经传导阻滞(CB)与神经节苷脂抗体在吉兰-巴雷综合征(GBS)患者中的诊断及预后评估价值。方法选取2018年1月至2022年8月郑州市中心医院收治并诊断为急性运动轴索神经病(AMAN)为AMAN组或急性炎性脱髓鞘性多发神经根神经病(AIDP)为AIDP组的患者共34例,回顾性分析两组的临床特点及神经电生理特点,并比较两组伴或不伴神经CB及血清神经节苷脂抗体阳性与阴性患者在最高的Hughes评分和4周后Hughes评分下降的差异。结果本研究34例患者中AMAN 20例、AIDP 14例。AMAN组患者中有6例出现可逆性神经CB,与无神经CB的AMAN患者及伴神经CB的AIDP患者相比,Hughes评分下降,差异有统计学意义(P<0.05)。34例中血清神经节苷脂抗体阳性13例,其中AMAN 8例,AIDP 5例。神经节苷脂抗体阳性与阴性患者的Hughes评分下降值比较,差异无统计学意义(P>0.05)。结论伴有可逆性神经CB的AMAN患者临床恢复可能更快,优于不伴神经CB的AMAN患者及伴神经CB的AIDP患者。神经节苷脂抗体与GBS疾病短期预后可能无关。
Objective To explore the diagnostic and prognostic assessment values of nerve conduction block(CB)and ganglioside antibody in patients with Guillain-Barrésyndrome(GBS).Methods Retrospective analysis was run on clinical and neurophysiological characteristics of 34 patients diagnosed with acute motor axonal neuropathy(AMAN)or acute inflammatory demyelinating polyneuropathy(AIDP)admitted to Zhengzhou Central Hospital from January 2018 to August 2022.The differences in the highest Hughes score and the decrease in Hughes score after 4 weeks were compared between two groups of patients with positive and negative serum anti-ganglioside antibody,and between two groups of patients with nerve CB.Results Among the 34 patients in this study,there were 20 patients with AMAN(AMAN group)and 14 patients with AIDP(AIDP group).Six patients in the AMAN group experienced reversible nerve CB.There were significant differences in the decrease in Hughes scores between the patients with CB and the patients without CB in AMAN group,and between the patients with CB in AMAN group and the patients with CB in AIDP group(P<0.05).Among 34 patients,13 patients were positive for serum ganglioside antibody,including 8 patients in AMAN group and 5 patients in AIDP group.There is no statistically significant difference in the decrease in Hughes scores between patients with positive and negative ganglioside antibody(P>0.05).Conclusion AMAN patients with reversible nerve CB might have fast clinical recovery,better than AMAN patients without nerve CB and AIDP patients with nerve CB.Ganglioside antibody might not be associated with the short-term prognosis of GBS.
作者
张凯华
杨硕
卜淑芳
ZHANG Kaihua;YANG Shuo;BU Shufang(The Sixth Ward of Neurology Department,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou(450000),Henan,China)
出处
《癫痫与神经电生理学杂志》
2024年第1期26-30,共5页
Journal of Epileptology and Electroneurophysiology(China)
基金
河南省医学科技攻关计划项目(LHGJ20220857)。
