大剂量丙种球蛋白治疗吉兰-巴雷综合征的疗效观察

Observation of the human gamma globulin treatment with high dose in acute Guiilian-Barre syndrome

目的观察大剂量静脉注射人血免疫球蛋白（intravenous immune globulin，IVIG）治疗吉兰-巴雷综合征（GBS）的临床疗效。方法回顾性分析39例GBS患者的临床资料，其中IVIG治疗组28例，按体质量0．4g／（kg·d）给予IVIG治疗，疗程5～20d，平均（9．43±4．96）d；糖皮质激素治疗组11例，给予地塞米松10～20mg／d治疗，10d后逐渐减量。比较两组患者治疗效果，同时对IVIG治疗的起始时间、疗程及发病严重程度与疗效的关系进行相关分析。结果IVIG治疗组疗效明显优于糖皮质激素治疗组（P〈0．05）；IVIG用药起始时间（r=-0．441，P〈0．05）、疗程（r=0．403，P〈0．05）及发病严重程度（r=0．576，P〈0.05）与疗效具有相关性。结论IVIG治疗GBS疗效优于糖皮质激素治疗，早期、足量、足疗程行IVIG治疗对GBS患者疗效至关重要。

Objective To observe the curative effect of the human gamma globulin treatment with high dose in acute Guillian-Barre syndrome （GBS）. Methods Retrospective analysis was conducted among 39 cases, and they were divided into the intravenous immune globulin （IVIG） treated group and dexamethasone treated group. 28 cases received IVIG [0.4 mg/ （kg· d）] for 5-20 days, whereas 11 cases received intravenous dexamethasone 10-20 mg/d for 10 days, then reduced the dosage gradularly. Other supportive therapies were regularly common. The grades were evaluated before and after treatment respectively according to Hughes scale, then the curative effect and the decrease status of the Hughes grade of the two groups were compared by SPSS software. Meanwhile, the curative effect of IVIG group was analyzed, including the start time of the treatment, the course of therapy and the severity of initial stage of GBS by using Pearson correlation. Results The therapy effect of IVIG group was significantly better than that of dexametbasone group （P 〈 0.05）. There were significantly correlation among the start time of the treatment （r= -0. 441, P〈0.05）, the course of therapy （r=0. 403, P〈0.05） and the severity of initial stage （r=0. 576, P〈0.05） with the curative effect. Conclusions The IVIG therapy for initial stage of GBS patients was superior to that of dexamethasone group. It was very important to apply IVIG treatment among GBS patients, as early as possible, as sufficiency as possible and as long as possible.