吉兰-巴雷综合征早期电生理变化特点分析

目的：分析吉兰-巴雷综合征（GBS）早期（1～7d）的电生理改变特点，探讨其对GBS的早期诊断价值。方法：采用回顾性分析方法对69例GBS患者的电生理检测结果与临床特点进行分析，比较发病7d之内和大于7d的神经电生理变化特点。结果：运动神经传导速度（MCV）的异常率为55％，发病7d内为45％，发病7d后为55％；F波异常率为77％，发病7d内为52％，发病7d后为48％，感觉神经传导速度（SCV）异常率为52％，发病7d内及7d后均为50％；运动神经复合肌肉动作电位（CMAP）波幅降低异常率为64％，发病7d内为52％，发病7d后为48％；上肢感觉神经动作电位（SNAP）异常同时伴有腓肠神经SNAP正常者占39％，发病7d内占44％，发病7d后为56％。结论：GBS患者早期（7d之内）即可出现神经传导速度、F波、运动及感觉神经传导的改变，以F波更为明显，因此神经电生理检查在GBS中的早期诊断具有重要的作用。

Characteristics of the early electrophysiology in patients with Guillain-Barre syndrome

Objective.. To analyze the early electrophysiological characteristic of Guillain-Barre syndrome （GBS） and to discuss its value of the diagnosis in the early stage of GBS. Methods.. Retrospective analysis method was used to assess the electrophysiological examination and clinical characteristis in 69 patients,with GBS. The electrophysiological characteristic within 7 days after the onset of symptom and that of more than 7 days after the onset of symptom were analyzed respectively. Results：The motor NCV was abnormal in 55~ of the patients,within 7 days after symptom in 450/00 and in 7 days and after more than 7 days in 50%. The F waves were abnormal in 77% ,in 52% and after more than 7 days in 48%. The sensory NCV was abnormal in 52 % of the patients,within 7days and after more than 7 days in 50 %. The （compound muscle action potential（CMAP） amplituded decreased in 64 % of the patients, within 7days in 52 % after the onset of symptom and after more than 7 clays in 48%. Abnormal upper extremity SNAP accompany a normal sural SNAP account for 39%,within 7days after the onset of symptom in 44% and after more than 7 days in 56 %. Conclusion.. NCV,F waves, abnormal upper extremity SNAP/ normal sural SNAP are effective and important auxiliary examination for diagnosis in the early stage of GBS. They can improve the diagnosis level.