吉兰-巴雷综合征脑脊液蛋白与面神经瘫痪的相关性

目的探讨吉兰-巴雷综合征(Guillain-Barre Snydrome,GBS)患者脑脊液蛋白与面神经瘫痪的关系及其临床意义。方法回顾性分析2005年1月至2015年9月我院神经内科确诊的111例GBS患者临床与生化资料,根据面神经瘫痪将患者分为面神经正常组与瘫痪组,比较两组患者间的临床、生化特征;根据脑脊液蛋白值将患者分为脑脊液蛋白正常组、轻度偏高组与异常偏高组,比较3组间面神经瘫痪数量的变化;分析脑脊液蛋白与面神经瘫痪的相关性。结果面神经正常组与瘫痪组之间患者性别、年龄、残疾量表评分(≥3)、上呼吸道感染、胃肠感染、肺部感染及近期疫苗接种史比较无统计学差异(P0.05),脑脊液蛋白、免疫球蛋白G(Ig G)、脑脊液白蛋白/血清白蛋白(QALB)比较有统计学差异(P0.05);3组不同脑脊液蛋白水平患者面神经瘫痪数量比较有统计学差异(F=3.48,P=0.03);脑脊液蛋白水平与面神经瘫痪数量呈正相关(r=0.288,P0.01)。结论 GBS患者脑脊液蛋白值越高面神经瘫痪发生的可能性越大,脑脊液蛋白有助于GBS患者面神经瘫痪的病情监测。

The correlation between cerebrospinal fluid protein and facial paralysis in patients with Guillain-Barre ;syndrome

Objectives To explore the correlation between the cerebrospinal fluid protein and facial paralysis in pa?tients with Guillain-Barre syndrome (GBS). Methods Clinical and biochemical data of 111 patients with GBS in depart?ment of neurology from January 2005 to September 2015 were retrospectively analyzed. According to facial paralysis, GBS patients were divided into the facial normal and paralysis groups. Their clinical and biochemical characteristics were compared between the two groups. According to level of cerebrospinal fluid protein, GBS patients were divided into cerebrospinal fluid protein normal, mild high and severe high groups. Incidences of facial paralysis were compared among these three groups. The correlation between the cerebrospinal fluid protein and facial paralysis was analyzed. Results There was no significant difference in gender, age, respiratory infection and other clinical symptoms (P>0.05), whereas there were statistically significant differences in cerebrospinal fluid protein, immunoglobulin G, and cerebrospinal fluid albumin/serum albumin ratio between the facial normal and paralysis groups (P<0.05). Among the three groups by differ?ent levels of cerebrospinal fluid protein, there were statistically significant differences in the incidence of facial paralysis (F=3.48,P=0.03). Cerebrospinal fluid protein was positively correlated with facial paralysis (r=0.288,P<0.01). Conclu? sions The incidence of facial paralysis is associated with the levels of cerebrospinal fluid protein. Thus, cerebrospinal flu?id protein may be helpful in monitoring of GBS patients with facial paralysis.