格林-巴利综合征的预后因素分析

目的　进一步明确与格林 巴利综合征 (GBS)预后相关的因素。方法　 (1)将 47名病人分为A组 (恢复较快 ) 9例和B组 (恢复较慢 ) 3 8例 ,比较两组在年龄、性别、进展期、最大Hughes评分、颅神经受累和腱反射等方面的差别。 (2 )根据电生理表现将 2 2例病人分为急性感染性脱髓鞘多神经根病 (AIDP)组 14例和急性运动性轴索型神经病 (AMAN )组 8例 ,比较其Hughes评分的动态变化。 (3 )根据治疗措施将 47例患者分为单纯激素组 3 9例和激素合并IVIg组 8例 ,比较两组用药后症状好转时间的差异。结果　A组病人最大Hughes评分低于B组 (P <0 .0 1) ,腱反射保留和IVIg治疗的人数较B组多 (P <0 .0 5 )。AMAN组患者的最大Hughes评分高于AIDP组 (P <0 .0 5 ) ,且第 3、4周改善的评分 (较病情高峰 )亦少于AIDP组 (P分别 <0 .0 1,<0 .0 5 )。IVIg合并激素组症状好转的时间早于单纯激素组 (P <0 .0 5 )。 结论　大剂量IVIg治疗、周围神经脱髓鞘改变、腱反射存在及较低的Hughes评分等因素可能与较良好的预后相关。

Analysis on Prognostic Factors of Guillain-Barre Syndrome

Objective To investigate the factors related to the prognosis of Guillain-Barre syndrome(GBS).Method (1)47 patients were divided into group A(rapid recovery,n=9) and group B(slow recovery,n=38).The differences between two groups in the age,sex,progress stage,maximal Hughes grade,involvement of cranial nerve and tendon reflex were compared.(2)22 patients were divided into acute inflammatory demyelinating ployradiculopathy(AIDP) group(n=14) and acute motor axonal neuropathy(AMAN) group(n=8) according to their electrophysiological manifestation.The dynamic changes of their Hughes grade were compared.(3)8 patients were treated with prednisone and large dose IVIg while 39 patients with prednisone only.The difference in time of symptom improved after medication between two groups was compared.Results The maximal Hughes grade of group A was lower than that of group B( P <0.01).The patients with tendon reflex retention and treated with IVIg in group A were more than those in group B( P <0.05).The maximal Hughes grade in AMAN group was higher than that in AIDP group( P <0.05),and the improved grade(compared with that in peak stage) in AMAN group in third and forth weeks were less than that in AIDP group( P<0.01,P <0.05,respectively).The time of symtom improved in IVIg group was earlier than that in prednisone group( P <0.05).Conclusions Large dose IVIg therapy,main demyelinative electrophysiological change,retention of tendon reflex and lower maximal Hughes grade may be related to a better prognosis.