摘要
目的分析吉兰-巴雷综合征(Guillain-Barre syndrome,GBS)患者早期临床特点和电生理学检查,并探讨其病情进展严重程度的相关因素。方法收集2003-08-2007-09北京协和医院收治的GBS患者77例,患者病情等级根据Hughes评分划分,针对患者发病年龄是否大于40岁、是否存在延髓及自主神经症状、病情最重时双上肢近端肌力总和是否≤5分、双上肢F波出现率是否≤50%等指标进行评估。结果急性期患者病情严重程度与自主神经功能障碍(P=0.012)、双上肢近端肌力总和≤5分(P=0.018)有关。重症患者较轻症患者发病年龄偏大、延髓功能障碍、自主神经功能障碍、双上肢近端肌力总和≤5分、双上肢F波出现率≤50%等情况多见。死亡患者2例(2.59%),主要死因为心跳、呼吸骤停。结论存在双上肢近端肌力差、自主神经功能障碍的GBS患者病情相对较重。对于重症患者尤其存在延髓功能障碍者,临床医生应注意其呼吸和心脏异常情况,以防患者出现呼吸衰竭及心搏骤停而危及生命。
Objective Assessment of early clinical characteristics and electrophysiology in patients with Guillain-Barre syndrome （GBS）, exploration the main predictors relating to the progression of disease. Methods Records of patients with GBS admitted between August 2003 and September 2007 from Perking Union Medical College Hospital were evaluated, and Hughes scale was used to evaluate the clinical status of patients. Results A worse Hughes score at nadir in the acute phase of their illness was related to autonomic nervous system involvement （P=O. 012）, upper limb paralysis（P=0. 018）. The severe patients were more frequently older,had bulbar dysfunction, had autonomic nervous system involvement, had the strength of upper proximal limbs≤5 and the frequency of occurrence of the F-waves in limbs≤50%. Mortality was 2.59% in this study. Conclusions Upper limb paralysis, autonomic nervous system involvement almost happened in the severe patients with GBS. These severe patients, especially had bulbar dysfunction, had to paid more attention by the clinician, in order to prevent them from respiratory failure, cardiac arrest.
出处
《中国神经免疫学和神经病学杂志》
CAS
2009年第1期8-11,共4页
Chinese Journal of Neuroimmunology and Neurology
