免疫球蛋白对重症格林-巴利综合征的治疗效果评价

The value of immunoglobulin in severe Guillain-Barre syndrome treatment

目的探讨静脉注射免疫球蛋白(IVIG)对重症格林-巴利综合征(GBS)的治疗价值。方法将58例重症GBS患者分为两组:IVIG组和激素组。两组均以维生素B族、神经保护、改善血循环及对症支持治疗为基础。区别是IVIG组应用IVIG 0.4 g.kg-1.d-1,5 d为1个疗程,激素组急性期应用地塞米松20-30mg/d冲击,以后逐渐减量停药。结果IVIG组疗效明显优于激素组(P<0.05)。与激素组比较IVIG组起效时间短,呼吸肌麻痹发生率低,病程明显缩短,病死率明显下降。结论大剂量IVIG治疗重症GBS疗效确切,可以大大降低病死率,应该作为首选治疗。

Objective To explore the value of intravenous immunoglobulin in Guillain-Barre syndrome treatment for severe patients. Methods 58 cases were divided into two groups： IVIG group and corticosteroids（CS） group. IVIG group were given IVIG, whereas CS group were given CS. For the two groups, other therapies were common. Results The effect in IVIG group was much more significant than that in CS group（P 〈 0.05 ）. Compared with CS group in IVIG group patients symptoms got alleviated within a shorter time;The rate of respiratory paralysis was lower;The recovery time was shorter and the mortality was much lower. Conclusion IVIG is a trusty therapy. To severe GELS, high doses IVIG can effectively prevent the occurrence of respiratory paralysis and inhibit its development. IVIG can greatly decrease the mortality of severe GBS,so IVIG should be chosen to use firstly.